Science.gov

Sample records for management reduces injection-related

  1. Reducing the risk, managing safety.

    PubMed

    Aldridge, Peter

    2016-02-01

    Fire safety in healthcare premises has always been a challenge to those that discharge this duty. Statutory compliance should be a matter of course, but in an ever increasingly challenged NHS, even this is not a given. While the NHS is driven by managing very complex risk to deliver cutting edge healthcare, providers cannot be risk averse. Which risk, however, takes priority? Here Peter Aldridge, fire and corporate services manager at Leeds Teaching Hospitals NHS Trust, and Secretary to the National Association of Healthcare Fire Officers (NAHFO)--which will this month and next jointly stage fire safety seminars with IHEEM; see page 8--considers the key issues, with input from a fire officer at a leading mental health and community Trust. PMID:27017658

  2. Poultry litter moisture management to reduce ammonia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ammonia generation in poultry houses results from the natural breakdown of litter (bedding material mixed with deposits of feces, feathers, spilled feed and water). Good management practices can reduce ammonia concentrations in poultry houses. This factsheet relates findings from a recent publicat...

  3. Fisheries management to reduce contaminant consumption

    SciTech Connect

    Stow, C.A.; Jackson, L.J.; Eby, L.A.

    1995-12-01

    Lake Michigan is a microcosm of global environmental issues. A history of problems has plagued the lake, arising from the wide range of human activities the basin supports. Much of Lake Michigan`s watershed is agriculturally developed, and the shoreline is dotted with major urban, industrial centers. The lake has supported important commercial shipping and fishing industries for more than a century. In the 1960s and 1970s eutrophication was a concern. More recently toxic contaminants, particularly PCBs, and invasions by exotic species, such as the zebra mussel (Dreissena polymorpha), have captured headlines. More than 200 years of development and exploitation have taken Lake Michigan far from a pristine state. The Lake Michigan fishery in intensively managed, and food web manipulation may more effectively reduce PCB exposure than cleanup activities do. Four management options are discussed in this article: trophic cascade; growth maximization; size of stocked fish; and selective species stocking. The most promising option, well supported by data is in many ways the simplist: selective stocking of species that accumulate contaminants at the lowest levels. 51 refs., 6 figs., 1 tab.

  4. LeRC reduced gravity fluid management technology program

    NASA Technical Reports Server (NTRS)

    Aydelott, J. C.; Symons, E. P.

    1980-01-01

    A survey of the reduced gravity fluid management technology program is presented. Information on reduced gravity fluid behavior, techniques for thermal control of cryogenic tankage, and design for fluid management systems are discussed. The development of Spacelab experiments, propellant management systems for orbit transfer vehicles, and computer techniques for simulating reduced gravity fluid dynamic processes is reported.

  5. Managing biogeochemical cycles to reduce greenhouse gases

    SciTech Connect

    Post, Wilfred M; Venterea, Rodney

    2012-01-01

    This special issue focuses on terrestrial biogeochemical cycles as they relate to North America-wide budgeting and future projection of biogenic greenhouse gases (GHGs). Understanding the current magnitude and providing guidance on the future trajectories of atmospheric concentrations of these gases requires investigation of their (i) biogeochemical origins, (ii) response to climate feedbacks and other environmental factors, and (iii) susceptibility to management practices. This special issue provides a group of articles that present the current state of continental scale sources and sinks of biogenic GHGs and the potential to better manage them in the future.

  6. New system reduces sludge management costs

    SciTech Connect

    Roll, R.R. ); Koser, M.R. )

    1993-06-01

    This article describes a recently completed a $2.7-million project to upgrade the sludge dewatering and stabilizing system at a 48-mgd wastewater treatment facility in Niagara Fall, New York. The work was necessitated by the deteriorated condition of the plant's original vacuum filters and increasing costs to landfill the dewatered sludge. The new equipment has restored sludge production capacity while reducing the final material's moisture content. The Niagara Falls plant is one of the few municipal physical-chemical treatment plants built in this country, and is the largest still functioning. Constructed in the mid-1970s, it was designed to treat a combination of domestic sewage and industrial wastes. One third of the flow and one half of the solids are industrial in nature. The changes made reduced electrical power consumption and sanitary landfill costs.

  7. Fisheries management to reduce contaminant consumption

    USGS Publications Warehouse

    Stow, Craig A.; Carpenter, Stephen R.; Madenjian, Charles P.; Eby, Lisa A.; Jackson, Leland J.

    1995-01-01

    This paper concludes that contaminants in Lake Michigan fishes are likely to remain above detectable levels for some time. Some interest groups have called for measures ranging from additional effluent controls to a ban on the industrial use of chlorine. Such measures, however well intended, are likely to have little impact on many of the contaminants of primary concern. PCBs, in particular, are largely the legacy of past activities and are not likely to be substantially affected by additional regulation. The authors review several options for reducing human exposure to PCBs, using relatively simple fisheries manipulations, although they do not propose that these measures are the ultimate solution to the contaminant problem. Of the options presented, the most promising is the replacement of lake trout with less-contaminated species, such as rainbow trout.

  8. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

    PubMed

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

    2014-04-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks. PMID:24694328

  9. THE STAYING SAFE INTERVENTION: TRAINING PEOPLE WHO INJECT DRUGS IN STRATEGIES TO AVOID INJECTION-RELATED HCV AND HIV INFECTION

    PubMed Central

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M.; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R.

    2014-01-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks. PMID:24694328

  10. Reducing uncertainty about objective functions in adaptive management

    USGS Publications Warehouse

    Williams, B.K.

    2012-01-01

    This paper extends the uncertainty framework of adaptive management to include uncertainty about the objectives to be used in guiding decisions. Adaptive decision making typically assumes explicit and agreed-upon objectives for management, but allows for uncertainty as to the structure of the decision process that generates change through time. Yet it is not unusual for there to be uncertainty (or disagreement) about objectives, with different stakeholders expressing different views not only about resource responses to management but also about the appropriate management objectives. In this paper I extend the treatment of uncertainty in adaptive management, and describe a stochastic structure for the joint occurrence of uncertainty about objectives as well as models, and show how adaptive decision making and the assessment of post-decision monitoring data can be used to reduce uncertainties of both kinds. Different degrees of association between model and objective uncertainty lead to different patterns of learning about objectives. ?? 2011.

  11. Injection Related Background due to the Transverse Feedback

    SciTech Connect

    Decker, F.J.; Akre, R.; Fisher, A.; Iverson, R.; Weaver, M.; /SLAC

    2008-03-18

    The background in the BaBar detector is especially high during injection, when most components are actually having reduced voltages. The situation is worse for the beam in High Energy Ring (HER) when the LER beam is present. It was found that the transverse feedback system plays an important role when stacking more charge on top of existing bunches. Lowering the feedback gain helped and it was realized later that the best scenario would be to gate off the feedback for only the one bunch, which got additional charge injected into it. The explanation is that the blown-up, but centered, original HER bunch plus the small injected off-axis bunch (each with half the charge) would stay in the ring if not touched, but the feedback system sees half the offset and wants to correct it, therefore disturbing and scraping the blown-up part.

  12. Reducing Pesticide and Nutrient Runoff from Fairways Using Management Practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We designed experiments to measure the quantity of fertilizers and pesticides transported with runoff from golf course fairway turf, and to evaluate the ability of management practices to reduce the transport of applied chemicals with runoff. Overall aeratation of fairway turf with hollow tines redu...

  13. Manure management in reduced tillage and grassland systems: A review

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Managing manure in reduced tillage systems remains a major concern, because tillage has traditionally been used to incorporate manure. Surface applied manure that is not incorporated into soil provides inefficient delivery of manure nutrients to crops due to environmental losses of nutrients and ser...

  14. Peer-Assisted Leadership: Reducing Educational Managers' Professional Isolation.

    ERIC Educational Resources Information Center

    Dussault, Marc; Barnett, Bruce G.

    1996-01-01

    Presents a study that verified the effects of the peer-assisted leadership program (PAL) on communication networks and professional isolation of 41 Quebec educational managers, using a one-group pretest posttest design. Results showed that PAL significantly reduced professional isolation without widening participants' communication networks. (34…

  15. Can managed care reduce employers' retiree medical liability?

    PubMed

    Taylor, R S; Newton, B

    1991-01-01

    The Financial Accounting Standards Board (FASB) has forced U.S. companies to look squarely at their current retiree health obligations and their future commitments. Accounting Statement No. 106 (FAS 106) requires employers to accrue liabilities for retiree health benefits during employees' active service, rather than record the costs as benefits are paid. Employers are scrambling to find ways to reduce the statement's effect on corporate balance sheets. While managed health care has been increasingly employed to control benefit costs in active employee health plans, it has not been as popular in retiree plans. This article reviews important demographic and health trends in the retiree population and summarizes employers' early responses to FAS 106. It explores why managed health care has thus far played a limited role in reducing employers' postretirement medical liability, and offers insight into how that role could be increased in the future. PMID:10116958

  16. Forest management strategies for reducing carbon emissions, the French case

    NASA Astrophysics Data System (ADS)

    Valade, Aude; Luyssaert, Sebastiaan; Bellassen, Valentin; Vallet, Patrick; Martin, Manuel

    2015-04-01

    International agreements now recognize the role of forest in the mitigation of climate change through the levers of in-situ sequestration, storage in products and energy and product substitution. These three strategies of carbon management are often antagonistic and it is still not clear which strategy would have the most significant impact on atmospheric carbon concentrations. With a focus on France, this study compares several scenarios of forest management in terms of their effect on the overall carbon budget from trees to wood-products. We elaborated four scenarios of forest management that target different wood production objectives. One scenario is 'Business as usual' and reproduces the current forest management and wood production levels. Two scenarios target an increase in bioenergy wood production, with either long-term or short-term goals. One scenario aims at increasing the production of timber for construction. For this, an empirical regression model was developed building on the rich French inventory database. The model can project the current forest resource at a time horizon of 20 years for characteristic variables diameter, standing volume, above-ground biomass, stand age. A simplified life-cycle analysis provides a full carbon budget for each scenario from forest management to wood use and allows the identification of the scenario that most reduces carbon emissions.

  17. Reputation management: evidence for ability but reduced propensity in autism.

    PubMed

    Cage, Eilidh; Pellicano, Elizabeth; Shah, Punit; Bird, Geoffrey

    2013-10-01

    Previous research has reported that autistic adults do not manage their reputation, purportedly due to problems with theory of mind [Izuma, Matsumoto, Camerer, & Adolphs]. The current study aimed to test alternative explanations for this apparent lack of reputation management. Twenty typical and 19 autistic adults donated to charity and to a person, both when alone and when observed. In an additional manipulation, for half of the participants, the observer was also the recipient of their donations, and participants were told that this observer would subsequently have the opportunity to donate to them (motivation condition). This manipulation was designed to encourage an expectation of a reciprocal "tit-for-tat" strategy in the participant, which may motivate participants to change their behavior to receive more donations. The remaining participants were told that the person watching was just observing the procedure (no motivation condition). Our results replicated Izuma et al.'s finding that autistic adults did not donate more to charity when observed. Yet, in the motivation condition, both typical and autistic adults donated significantly more to the observer when watched, although this effect was significantly attenuated in autistic individuals. Results indicate that, while individuals with autism may have the ability to think about reputation, a reduced expectation of reciprocal behavior from others may reduce the degree to which they engage in reputation management. PMID:23836550

  18. [Preoperative management to reduce morbidity and mortality of hip fracture].

    PubMed

    Ferré, F; Minville, V

    2011-10-01

    Hip femur is extremely common in the elderly and is one of the most common reasons for admission in trauma care. The main reported causes of death after hip fracture were cardiovascular (29%), neurological (20%) and pulmonary. Large epidemiological studies have shown a relatively small decrease in mortality for 20 years despite an active approach to medical and surgical management. Yet 57% of deaths occurring within 30 days post-surgery are preventable because they are not related to a pre-existing disease. Preoperative management to optimize these patients could help to reduce morbidity and mortality and is thus a crucial issue. The anesthesia consultation is used to evaluate the perioperative risk, treat pain, manage treatment and stabilize the patient. An operative delay of more than 48hours after admission increases mortality. This period should not be prolonged by unnecessary investigations that will not change the perioperative management. The preoperative period is a key moment because it allows to choose the anesthetic technique. Even if this choice is controversial, continuous spinal anesthesia (titrated) do not modify the cardiovascular and neurological physiological balance of these precarious patients. PMID:21945704

  19. Reducing Wildlife Damage with Cost-Effective Management Programmes

    PubMed Central

    Krull, Cheryl R.; Stanley, Margaret C.; Burns, Bruce R.; Choquenot, David; Etherington, Thomas R.

    2016-01-01

    Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control), with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting) undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation return. PMID

  20. Reducing Wildlife Damage with Cost-Effective Management Programmes.

    PubMed

    Krull, Cheryl R; Stanley, Margaret C; Burns, Bruce R; Choquenot, David; Etherington, Thomas R

    2016-01-01

    Limiting the impact of wildlife damage in a cost effective manner requires an understanding of how control inputs change the occurrence of damage through their effect on animal density. Despite this, there are few studies linking wildlife management (control), with changes in animal abundance and prevailing levels of wildlife damage. We use the impact and management of wild pigs as a case study to demonstrate this linkage. Ground disturbance by wild pigs has become a conservation issue of global concern because of its potential effects on successional changes in vegetation structure and composition, habitat for other species, and functional soil properties. In this study, we used a 3-year pig control programme (ground hunting) undertaken in a temperate rainforest area of northern New Zealand to evaluate effects on pig abundance, and patterns and rates of ground disturbance and ground disturbance recovery and the cost effectiveness of differing control strategies. Control reduced pig densities by over a third of the estimated carrying capacity, but more than halved average prevailing ground disturbance. Rates of new ground disturbance accelerated with increasing pig density, while rates of ground disturbance recovery were not related to prevailing pig density. Stochastic simulation models based on the measured relationships between control, pig density and rate of ground disturbance and recovery indicated that control could reduce ground disturbance substantially. However, the rate at which prevailing ground disturbance was reduced diminished rapidly as more intense, and hence expensive, pig control regimes were simulated. The model produced in this study provides a framework that links conservation of indigenous ecological communities to control inputs through the reduction of wildlife damage and suggests that managers should consider carefully the marginal cost of higher investment in wildlife damage control, relative to its marginal conservation return. PMID

  1. Management to reduce nitrogen losses in animal production.

    PubMed

    Rotz, C A

    2004-01-01

    Reduction of nitrogen loss in animal production requires whole-farm management. Reduced loss from one farm component is easily negated in another if all components are not equally well managed. Animal excretion of manure N can be decreased by improving the balance of protein or amino acids fed to that required by individual animals or animal groups or by improving production efficiency. Management to increase milk, meat, or egg production normally improves efficiency by reducing the maintenance protein required per unit of production. Large losses of manure nitrogen occur through the ammonia and nitrous oxide that are emitted into the atmosphere and the nitrate leached into groundwater. Up to half of the excreted nitrogen is lost from the housing facility, but this loss can be decreased through frequent manure removal and by avoiding deep litter systems and feedlots. Techniques such as acid treatment of manure, scrubbing of ventilation air, and floor designs for separating feces and urine substantially reduce ammonia emissions, but these practices are often impractical or uneconomical for general use. Manure storage units improve nutrient utilization by allowing better timing of nutrient application with crop needs. At least 70% of the nitrogen entering anaerobic lagoons is typically lost, but a less than 10% loss can be maintained using slurry storage with a natural crust or other cover, or by drying poultry manure to at least 50% dry matter. Irrigation and surface spreading of manure without soil incorporation often ensures the loss of all remaining nonorganic nitrogen (typically, 20 to 40% of remaining nitrogen). Rapid incorporation and shallow injection methods decrease this loss by at least 50%, and deep injection into the soil essentially eliminates this loss. For grazing animals, excessive loss can be avoided by not overstocking pastures and avoiding late fall and winter grazing. Reducing emissions between the animal and the soil can lead to greater leaching

  2. Reducing uncertainty in managing respiratory tract infections in primary care

    PubMed Central

    Stanton, Naomi; Francis, Nick A; Butler, Chris C

    2010-01-01

    Respiratory tract infections (RTIs) remain the commonest reason for acute consultations in primary care in resource-rich countries. Their spectrum and severity has changed from the time that antibiotics were discovered, largely from improvements in the socioeconomic determinants of health as well as vaccination. The benefits from antibiotic treatment for common RTIs have been shown to be largely overstated. Nevertheless, serious infections do occur. Currently, no clinical features or diagnostic test, alone or in combination, adequately determine diagnosis, aetiology, prognosis, or response to treatment. This narrative review focuses on emerging evidence aimed at helping clinicians reduce and manage uncertainty in treating RTIs. Consultation rate and prescribing rate trends are described, evidence of increasing rates of complications are discussed, and studies and the association with antibiotic prescribing are examined. Methods of improving diagnosis and identifying those patients who are at increased risk of complications from RTIs, using clinical scoring systems, biomarkers, and point of care tests are also discussed. The evidence for alternative management options for RTIs are summarised and the methods for changing public and clinicians' beliefs about antibiotics, including ways in which we can improve clinician–patient communication skills for management of RTIs, are described. PMID:21144191

  3. Invited review: reduced milking frequency: milk production and management implications.

    PubMed

    Stelwagen, K; Phyn, C V C; Davis, S R; Guinard-Flament, J; Pomiès, D; Roche, J R; Kay, J K

    2013-06-01

    Most dairy cows throughout the world are milked twice daily. In intensive dairying systems, however, it is not uncommon to increase milking frequency to between 3 and 6 times daily to increase milk production. Reducing milking frequency is much less common; however, once-daily milking of dairy cows, practiced either strategically during certain parts of the lactation or for the entire lactation, is not uncommon in key dairying countries where less emphasis is placed on milk production per cow. The practice fits well with more extensive dairy production systems, particularly those based on grazed pasture. A feature of once-daily milking is that it reduces milk yield by approximately 22%, depending on stage of lactation, breed, and parity, and it may adversely affect lactation length and persistency. However, it can offer several positive farm management options, especially related to labor requirements and farm working expenses. In addition, it may provide a tool to better manage the metabolism and energy balance of cows during early lactation or during periods of pasture deficit, and it may help to improve reproductive performance and animal health and welfare. Once-daily milking, representing one extreme of the mammary function spectrum, has attracted considerable research interest over the years. Consequently, substantial scientific information is available on its effects on mammary function, at both the physiological and molecular levels. This review focuses instead on the management of the cow milked once daily, covering the production response in relation to breed, stage of lactation, and parity, and its effect on energy status, reproduction, health and welfare, as well as on milk composition and processability. PMID:23548302

  4. Use of Integrated Malaria Management Reduces Malaria in Kenya

    PubMed Central

    Okech, Bernard A.; Mwobobia, Isaac K.; Kamau, Anthony; Muiruri, Samuel; Mutiso, Noah; Nyambura, Joyce; Mwatele, Cassian; Amano, Teruaki; Mwandawiro, Charles S.

    2008-01-01

    insecticide treated bed net and 81% reported buying the nets within the last 5 years. The community also used mosquito reduction measures including, in order of preference, environmental management (35%), mosquito repellent and smoke (31%) insecticide canister sprays (11%), and window and door screens (6%). These methods used by the community comprise an integrated malaria management (IMM) package. Over the last 4 years prior to this study, the malaria cases in the community hospital reduced from about 40% in 2000 to less than 10% by 2004 and by the year 2007 malaria cases decreased to zero. In addition, a one time cross-sectional malaria parasite survey detected no Plasmodium infection in 300 primary school children in the area. Mosquito vector populations were variable in the six villages but were generally lower in villages that did not engage in irrigation activities. The malaria risk as estimated by EIR remained low and varied by village and proximity to irrigation areas. The average EIR in the area was estimated at 0.011 infectious bites per person per day. Conclusions The usage of a combination of malaria control tools in an integrated fashion by residents of Mwea division might have influenced the decreased malaria cases in the district hospital and in the school children. A vigorous campaign emphasizing IMM should be adopted and expanded in Mwea division and in other areas with different eco-epidemiological patterns of malaria transmission. With sustained implementation and support from community members integrated malaria management can reduce malaria significantly in affected communities in Africa. PMID:19115000

  5. Evaluation of a case management service to reduce sickness absence

    PubMed Central

    Smedley, Julia; Harris, E. Clare; Cox, Vanessa; Ntani, Georgia; Coggon, David

    2013-01-01

    Background It is unclear whether and to what extent intensive case management is more effective than standard occupational health services in reducing sickness absence in the healthcare sector. Aims To evaluate a new return to work service at an English hospital trust. Methods The new service entailed intensive case management for staff who had been absent sick for longer than four weeks, aiming to restore function through a goal-directed and enabling approach based on a bio-psycho-social model. Assessment of the intervention was by controlled before and after comparison with a neighbouring hospital trust at which there were no major changes in the management of sickness absence. Data on outcome measures were abstracted from electronic databases held by the two trusts. Results At the intervention trust, the proportion of 4-week absences which continued beyond 8 weeks fell from 51.7% in 2008 to 49.1% in 2009 and 45.9% in 2010. The reduction from 2008 to 2010 contrasted with an increase at the control trust from 51.2% to 56.1% – a difference in change of 10.7% (95%CI 1.5% to 20.0%). There was also a differential improvement in mean days of absence beyond four weeks, but this was not statistically significant (1.6 days per absence, 95%CI −7.2 to 10.3 days). Conclusion Our findings suggest that the intervention was effective, and calculations based on an annual running cost of £57,000 suggest that it was also cost-effective. A similar intervention should now be evaluated at a larger number of hospital trusts. PMID:23365116

  6. The longitudinal association between homelessness, injection drug use, and injection-related risk behavior among persons with a history of injection drug use in Baltimore, MD

    PubMed Central

    Linton, Sabriya L.; Celentano, David D.; Kirk, Gregory D.; Mehta, Shruti H.

    2013-01-01

    Background Few studies have assessed the temporal association between homelessness and injection drug use, and injection-related risk behavior. Methods Among a cohort of 1,405 current and former injection drug users in follow-up from 2005–2009, we used random intercept models to assess the temporal association between homelessness and subsequent injection drug use, and to determine whether the association between homelessness and sustained injection drug use among active injectors differed from the association between homelessness and relapse among those who stopped injecting. We also assessed the association between homelessness and subsequent injection-related risk behavior among participants who injected drugs consecutively across two visits. Homelessness was categorized by duration: none, <1 month, and ≥1 month. Results Homelessness was reported on at least one occasion by 532 (38%) participants. The relationship between homelessness and subsequent injection drug use was different for active injectors and those who stopped injecting. Among those who stopped injecting, homelessness was associated with relapse [<1 month: AOR=1.67, 95% CI (1.01, 2.74); ≥1 month: AOR=1.34 95% CI (0.77, 2.33)]. Among active injectors, homelessness was not associated with sustained injection drug use [<1 month: AOR=1.03, 95% CI (0.71, 1.49); ≥1 month: AOR=0.81 95% CI (0.56, 1.17)]. Among those injecting drugs across two consecutive visits, homelessness ≥1 month was associated with subsequent injection-related risk behavior [AOR=1.61, 95% CI (1.06, 2.45)]. Conclusion Homelessness appears to be associated with relapse and injection-related risk behavior. Strengthening policies and interventions that prevent homelessness may reduce injection drug use and injection-related risk behaviors. PMID:23578590

  7. Accident Precursor Analysis and Management: Reducing Technological Risk Through Diligence

    NASA Technical Reports Server (NTRS)

    Phimister, James R. (Editor); Bier, Vicki M. (Editor); Kunreuther, Howard C. (Editor)

    2004-01-01

    Almost every year there is at least one technological disaster that highlights the challenge of managing technological risk. On February 1, 2003, the space shuttle Columbia and her crew were lost during reentry into the atmosphere. In the summer of 2003, there was a blackout that left millions of people in the northeast United States without electricity. Forensic analyses, congressional hearings, investigations by scientific boards and panels, and journalistic and academic research have yielded a wealth of information about the events that led up to each disaster, and questions have arisen. Why were the events that led to the accident not recognized as harbingers? Why were risk-reducing steps not taken? This line of questioning is based on the assumption that signals before an accident can and should be recognized. To examine the validity of this assumption, the National Academy of Engineering (NAE) undertook the Accident Precursors Project in February 2003. The project was overseen by a committee of experts from the safety and risk-sciences communities. Rather than examining a single accident or incident, the committee decided to investigate how different organizations anticipate and assess the likelihood of accidents from accident precursors. The project culminated in a workshop held in Washington, D.C., in July 2003. This report includes the papers presented at the workshop, as well as findings and recommendations based on the workshop results and committee discussions. The papers describe precursor strategies in aviation, the chemical industry, health care, nuclear power and security operations. In addition to current practices, they also address some areas for future research.

  8. Reducing watershed scale phosphorus export through integrated management practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Phosphorus losses from golf course have been documented and are comparable to losses from agriculture and urban areas. Integrated management practices are required to address the problem. An integrated management approach using filter socks and limiting the amount of phosphorus applied to the golf c...

  9. Reducing environmental noise impacts: A USAREUR noise management program handbook

    NASA Astrophysics Data System (ADS)

    Feather, Timothy D.; Shekell, Ted K.

    1991-06-01

    Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

  10. Management Science/Industrial Engineering Techniques to Reduce Food Costs.

    ERIC Educational Resources Information Center

    Greenberg, Murray

    This paper examines the contributions of Industrial Engineering and Management Science toward reduction in the cost of production and distribution of food. Food processing firms were requested to respond to a questionnaire which asked for examples of their use of various operations research tools and information on the number of operations…

  11. Management Can Reduce Contamination Potential of Beef Backgrounding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Producers who want to “background” beef cattle on karst landscapes face great challenges. This is because without proper management, manure-borne contaminants from backgrounding sites can quickly degrade water quality in karst regions. Western Kentucky University and USDA-ARS reported on three-year ...

  12. Can weight management programs in worksites reduce the obesity epidemic?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Worksites can potentially be important locations for weight management programs that contribute to curbing the national obesity epidemic. In published studies, weight loss programs targeting overweight and obese employees have been relatively more effective for weight loss than programs for preventi...

  13. 81 FR 8504 - Recommendations for Donor Screening, Deferral, and Product Management To Reduce the Risk of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2016-02-19

    ... applicable disclosure law. For more information about FDA's posting of comments to public dockets, see 80 FR... Management To Reduce the Risk of Transfusion-Transmission of Zika Virus; Guidance for Industry; Availability... Screening, Deferral, and Product Management to Reduce the Risk of Transfusion-Transmission of Zika...

  14. Reducing the variability of compound management delivery using visual management systems.

    PubMed

    Spencer, Philip; Ratcliffe, Stuart; Cole, Shaun

    2014-04-01

    The globalization and externalization of a pharmaceutical company's research and development (R&D) places considerable demands on its underpinning compound management (CM) capability. More robust CM workflows are needed to support higher demands and cross-continent supply chains. The tracking and visibility of compound orders progressing through CM processes has become crucial to ensure prompt and reliable delivery to customers and project timelines worldwide. AstraZeneca at Alderley Park UK has successfully introduced and integrated a visual management system into its CM processes to support the company's global R&D strategy. A simple, low-cost approach has been employed to track solid processing and solubilization orders. This reduced variability and end-to-end cycle times by decreasing waiting time between processing steps. The visual tracking system has been quick to implement, adaptable to change, and able to be owned and run by delivery teams. Introduction of the visual tracking system has resulted in significant improvements in order processing, both in terms of variability and speed. The percentage of orders processed within 24 h rose from 81.5% to 92.5%, and reductions of 50% and 17.5% in the average processing time were seen for solid dispense and solubilization orders, respectively. PMID:23918922

  15. Management strategies to reduce risk of postoperative infections

    PubMed Central

    Galor, Anat; Goldhardt, Raquel; Wellik, Sarah R.; Gregori, Ninel Z.; Flynn, Harry W.

    2013-01-01

    Postoperative infections, although rare, are still of great concern to the ophthalmologist. The incidence of post-cataract endophthalmitis is low, with a range of .28 per 1,000 to 2.99 per 1000. In addition to intraoperative considerations such as poor wound construction, vitreous loss, topical anesthesia, and prolonged surgical time, other risk factors include preoperative factors such as a diseased ocular surface and systemic immunosuppression. Potential methods of reducing risk of endophthalmitis after anterior segment surgery are discussed and available literature is summarized. PMID:24319649

  16. Waste management: how reducing partiality can promote efficient resource allocation.

    PubMed

    Choshen-Hillel, Shoham; Shaw, Alex; Caruso, Eugene M

    2015-08-01

    Two central principles that guide resource-allocation decisions are equity (providing equal pay for equal work) and efficiency (not wasting resources). When these two principles conflict with one another, people will often waste resources to avoid inequity. We suggest that people wish to avoid inequity not because they find it inherently unfair, but because they want to avoid the appearance of partiality associated with it. We explore one way to reduce waste by reducing the perceived partiality of inequitable allocations. Specifically, we hypothesize that people will be more likely to favor an efficient (albeit inequitable) allocation if it puts them in a disadvantaged position than if it puts others in a disadvantaged position. To test this hypothesis, we asked participants to choose between giving some extra resource to one person (thereby creating inequity between this person and equally deserving others) and not giving the resource to anyone (thereby wasting the resource). Six studies, using realistic scenarios and behavioral paradigms, provide robust evidence for a self-disadvantaging effect: Allocators were consistently more likely to create inequity to avoid wasting resources when the resulting inequity would put them at a relative disadvantage than when it would put others at a relative disadvantage. We further find that this self-disadvantaging effect is a direct result of people's concern about appearing partial. Our findings suggest the importance of impartiality even in distributive justice, thereby bridging a gap between the distributive and procedural justice literatures. PMID:26075794

  17. Reducing cold-start emissions by catalytic converter thermal management

    SciTech Connect

    Burch, S D; Potter, T F; Keyser, M A; Brady, M J; Michaels, K F

    1995-01-01

    Vacuum insulation and phase-change thermal storage have been used to enhance the heat retention of a prototype catalytic converter. Storing heat in the converter between trips allows exhaust gases to be converted more quickly, significantly reducing cold-start emissions. Using a small metal hydride, the thermal conductance of the vacuum insulation can be varied continuously between 0.49 and 27 W/m{sup 2}K (R-12 to R-0.2 insulation) to prevent overheating of the catalyst. A prototype was installed in a Dodge Neon with a 2.0-liter engine. Following a standard preconditioning and a 23-hour cold soak, an FTP (Federal Test Procedure) emissions test was performed. Although exhaust temperatures during the preconditioning were not hot enough to melt the phase-change material, the vacuum insulation performed well, resulting in a converter temperature of 146{degrees}C after the 23-hour cold soak at 27{degrees}C. Compared to the same converter at ambient conditions, overall emissions of CO and HC were reduced by 52 % and 29 %, to 0.27 and 0.037 g/mile, respectively. The maximum converter temperature during the FTP cycle was 720{degrees}C. This limited testing was performed with a nearly-fresh palladium-only catalyst, but demonstrates the potential of this vacuum insulation approach for emissions reduction and thermal control. Further testing is ongoing. An initial assessment of several production issues is made, including high-volume fabrication challenges, durability, and cost.

  18. Inpatient management protocols to reduce health care costs.

    PubMed

    Wachtel, T; Moulton, A W; Pezzullo, J; Hamolsky, M

    1986-01-01

    A group of 12 internists, members of a university-affiliated hospital, designed and implemented protocols for the general inpatient management of four medical problems (chest pain, stroke, pneumonia, and upper gastrointestinal hemorrhage). Hospital charges for the 63 cases were compared with charges generated by 64 controls who had been patients admitted to the same physicians with the same diagnoses during the same period of the preceding year, before the project was begun. A group of nonparticipating internists was similarly evaluated during the two time periods to control for changes in practice patterns extraneous to the intervention. Adjustment was made for inflation (6%) and differences in case mix. The program resulted in a 15% reduction in total average charge generated by the cases. Sizeable reductions were achieved in utilization of EKGs (34.8%), x-rays (15.4%), laboratory testing (20.4%), and drugs (11.4%). Given the prevailing attitude that health care costs are too high and that many services are unnecessary, the benefit of altering physician behavior by using standards established by them for themselves could be substantial, especially with the threat of more restrictive and less sympathetic modes of controlling costs. PMID:3084902

  19. Reducing the cognitive workload: Trouble managing power systems

    NASA Technical Reports Server (NTRS)

    Manner, David B.; Liberman, Eugene M.; Dolce, James L.; Mellor, Pamela A.

    1993-01-01

    The complexity of space-based systems makes monitoring them and diagnosing their faults taxing for human beings. Mission control operators are well-trained experts but they can not afford to have their attention diverted by extraneous information. During normal operating conditions monitoring the status of the components of a complex system alone is a big task. When a problem arises, immediate attention and quick resolution is mandatory. To aid humans in these endeavors we have developed an automated advisory system. Our advisory expert system, Trouble, incorporates the knowledge of the power system designers for Space Station Freedom. Trouble is designed to be a ground-based advisor for the mission controllers in the Control Center Complex at Johnson Space Center (JSC). It has been developed at NASA Lewis Research Center (LeRC) and tested in conjunction with prototype flight hardware contained in the Power Management and Distribution testbed and the Engineering Support Center, ESC, at LeRC. Our work will culminate with the adoption of these techniques by the mission controllers at JSC. This paper elucidates how we have captured power system failure knowledge, how we have built and tested our expert system, and what we believe are its potential uses.

  20. Management Options For Reducing The Release Of Antibiotics And Antibiotic Resistance Genes To The Environment

    EPA Science Inventory

    Background: There is growing concern worldwide about the role of polluted soil and water - 77 environments in the development and dissemination of antibiotic resistance. 78 Objective: To identify management options for reducing the spread of antibiotics and 79 antibiotic resist...

  1. Creating Access to Invisible Special Collections: Using Participatory Management to Reduce a Backlog

    ERIC Educational Resources Information Center

    Lundy, M. Winslow; Hollis, Deborah R.

    2004-01-01

    The University of Colorado at Boulder Libraries used participatory management to reduce a special collections backlog. Without an increase in budget or staffing, technical and public services departments designed a pilot project to redeploy internal human resources in a collaborative manner. The process of backlog management is discussed.

  2. Managing a subsidized predator population: Reducing common raven predation on desert tortoises

    USGS Publications Warehouse

    Boarman, W.I.

    2003-01-01

    Human communities often are an inadvertent source of food, water, and other resources to native species of wildlife. Because these resources are more stable and predictable than those in a natural environment, animals that subsist on them are able to increase in numbers and expand their range, much to the detriment of their competitors and species they prey upon. In the Mojave Desert, common ravens (Corvus corax) have benefited from human-provided resources to increase in population size precipitously in recent years. This trend has caused concern because ravens prey on juvenile desert tortoises (Gopherus agassizii), a federally threatened species. In this paper, I discuss management strategies to reduce raven predation on desert tortoises. The recommendations fall into three categories: (1) managing raven populations by reducing access to anthropogenic resources; (2) removing offending ravens or other birds in specially targeted tortoise management zones; and (3) continuing research on raven ecology, raven behavior, and methods of reducing raven predation on tortoises. I also recommend approaching the problem within an adaptive management framework: management efforts should first be employed as scientific experiments - with replicates and controls - to yield an unbiased assessment of their effectiveness. Furthermore, these strategies should be implemented in concert with actions that reduce other causes of desert tortoise mortality to aid the long-term recovery of their populations. Overall, the approaches outlined in this paper are widely applicable to the management of subsidized predators, particularly where they present a threat to a declining species of prey.

  3. Use of Continuous Transdermal Alcohol Monitoring during a Contingency Management Procedure to Reduce Excessive Alcohol Use

    PubMed Central

    Dougherty, Donald M.; Hill-Kapturczak, Nathalie; Liang, Yuanyuan; Karns, Tara E.; Cates, Sharon E.; Lake, Sarah L.; Mullen, Jillian; Roache, John D.

    2014-01-01

    Background Research on contingency management to treat excessive alcohol use is limited due to feasibility issues with monitoring adherence. This study examined the effectiveness of using transdermal alcohol monitoring as a continuous measure of alcohol use to implement financial contingencies to reduce heavy drinking. Methods Twenty-six male and female drinkers (from 21–39 years old) were recruited from the community. Participants were randomly assigned to one of two treatment sequences. Sequence 1 received 4 weeks of no financial contingency (i.e., $0) drinking followed by 4 weeks each of $25 and then $50 contingency management; Sequence 2 received 4 weeks of $25 contingency management followed by 4 weeks each of no contingency (i.e., $0) and then $50 contingency management. During the $25 and $50 contingency management conditions, participants were paid each week when the Secure Continuous Remote Alcohol Monitor (SCRAM-II™) identified no heavy drinking days. Results Participants in both contingency management conditions had fewer drinking episodes and reduced frequencies of heavy drinking compared to the $0 condition. Participants randomized to Sequence 2 (receiving $25 contingency before the $0 condition) exhibited less frequent drinking and less heavy drinking in the $0 condition compared to participants from Sequence 1. Conclusions Transdermal alcohol monitoring can be used to implement contingency management programs to reduce excessive alcohol consumption. PMID:25064019

  4. A new frontier in healthcare risk management: Working to reduce avoidable patient suffering.

    PubMed

    Card, Alan J; Klein, Victor R

    2016-01-01

    This article presents a new avenue for healthcare risk managers to drive improvement for patients and healthcare organizations alike: working to reduce avoidable patient suffering. It briefly describes the problem of patient suffering, differentiates between avoidable and unavoidable suffering, and suggests that common risk management tools can be used to tackle the problem. It also highlights a success story from one large health system. PMID:26789746

  5. Does bacteriology laboratory automation reduce time to results and increase quality management?

    PubMed

    Dauwalder, O; Landrieve, L; Laurent, F; de Montclos, M; Vandenesch, F; Lina, G

    2016-03-01

    Due to reductions in financial and human resources, many microbiological laboratories have merged to build very large clinical microbiology laboratories, which allow the use of fully automated laboratory instruments. For clinical chemistry and haematology, automation has reduced the time to results and improved the management of laboratory quality. The aim of this review was to examine whether fully automated laboratory instruments for microbiology can reduce time to results and impact quality management. This study focused on solutions that are currently available, including the BD Kiestra™ Work Cell Automation and Total Lab Automation and the Copan WASPLab(®). PMID:26577142

  6. Evaluation of vegetable production management practices to reduce the ecological risk of pesticides

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The ability of agricultural management practices to reduce the ecological risks of pesticides was evaluated. Risk quotients, a mathematical description of the relationship between exposure and toxicity, and hazard ratings, a rank of potential risk of pesticides to aquatic environments, were calculat...

  7. Reducing the Environmental Risk of Pesticides: Implications of Management Practices in Agricultural Production

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A common management practice for the production of fresh-market vegetables uses polyethylene (plastic) mulch to increase soil temperature, maintain soil moisture and reduce weed pressure. However, multiple applications of fungicides and insecticides are required, and rain events afford more runoff ...

  8. Security Officer's Role in Reducing Inmate Problem Behaviors: A Program Based on Contingency Management.

    ERIC Educational Resources Information Center

    Ellis, Janet

    1993-01-01

    Describes guard-designed and implemented contingency-management work squad training program for administratively segregated prison inmates with histories of violent and assaultive behavior. Notes that participation in the work squad program sharply reduced frequency of violent and assaultive behavior for 8 of 10 offender-participants whose…

  9. Reducing the transport of pesticides with runoff from fairway turf using management practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Chemical pollutants have been detected in surface waters of urban and rural areas. As a result, attempts are being made to identify the sources of these compounds and reduce their inputs. The use of pesticides in highly managed turf systems has raised questions concerning the contribution of runoff ...

  10. Best management practices for reducing nutrient loads in a sub-watershed of Chesapeake Bay

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Water quality improvement in the Chesapeake Bay is a grave concern. An initiative to reduce the nutrient loads to stream has been undertaken to attain a target total maximum daily load (TMDL) at Chesapeake Bay. A general guideline with a set of best management practices (BMPs) has been in place for ...

  11. Best management practices for reducing nutrient loads in a sub-watershed of Chesapeake Bay area

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Water quality improvement in the Chesapeake Bay is a grave concern. An initiative to reduce the nutrient loads to stream has been undertaken to attain a target total maximum daily load (TMDL) at Chesapeake Bay. A general guideline with a set of best management practices (BMPs) has been in place for ...

  12. Management Practices Reduce Nutrient and Pesticide Loss with Runoff from Fairway Turf

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Excess nutrients and multiple pesticides have been detected in surface waters of urban and rural areas; raising questions concerning their source, potential environmental and health effects and the need to reduce these chemical inputs. Fertilizers and pesticides are used in the management of home la...

  13. Reducing Pesticide and Nutrient Loads with Runoff from Fairway Turf Utilizing Management Practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Water quality surveys have detected excess nutrients and multiple pesticides in surface waters of urban and rural areas. As a result, attempts are being made to identify the sources of these compounds and reduce their inputs. The use of fertilizers and pesticides in highly managed turf systems has r...

  14. Retaining Educational Fundraisers: Reducing Turnover by Investing in Human Capital Management

    ERIC Educational Resources Information Center

    Thomas, Christy

    2010-01-01

    This article outlines an approach to reducing gift officer turnover during comprehensive campaigns by investing in the human capital management (HCM) program. While many universities have begun to create HCM programs, I suggest creating a position specifically focused on the retention of gift offices to ensure that universities and non-profits can…

  15. A "Mental-Health-at-the-Workplace" Educational Workshop Reduces Managers' Stigma Toward Depression.

    PubMed

    Hamann, Johannes; Mendel, Rosmarie; Reichhart, Tatjana; Rummel-Kluge, Christine; Kissling, Werner

    2016-01-01

    Stigma and discrimination are important factors hindering people with mental health conditions to stay employed or successfully make their careers. We surveyed 580 German managers before and after visiting a "mental-health-at-the-workplace" educational workshop using the Depression Stigma Scale. The workshop significantly reduced stigma toward depression. Managers at baseline already exhibited lower stigma toward depression compared with the general population. In addition, female gender and higher education predicted lower stigma, which is in line with findings from other studies. We conclude that an educational workshop giving practical guidance regarding "mental-health-at-the-workplace" reduces managers' stigma toward depression and improves knowledge regarding depression, its course, and its treatment. PMID:26704465

  16. Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

    PubMed Central

    Pruden, Amy; Amézquita, Alejandro; Collignon, Peter; Brandt, Kristian K.; Graham, David W.; Lazorchak, James M.; Suzuki, Satoru; Silley, Peter; Snape, Jason R.; Topp, Edward; Zhang, Tong; Zhu, Yong-Guan

    2013-01-01

    Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance. Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action. Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture. Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action. Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action. PMID:23735422

  17. Evaluation of vegetable production management practices to reduce the ecological risk of pesticides.

    PubMed

    Rice, Pamela J; Hapeman, Cathleen J; McConnell, Laura L; Sadeghi, Ali M; Teasdale, John R; Coffman, C Benjamin; McCarty, Gregory W; Abdul-Baki, Aref A; Starr, James L

    2007-11-01

    The ability of agricultural management practices to reduce the ecological risks of pesticides was evaluated. Risk quotients, a mathematical description of the relationship between exposure and toxicity, and hazard ratings, a rank of the potential risk of pesticides to aquatic environments, were calculated for conventional and alternative cultivation practices for tomatoes: Poly-Bare, raised beds covered with polyethylene mulch with bare-soil furrows; Poly-Rye, raised beds covered with polyethylene mulch with cereal rye (Secale cereale) grown in the furrows; and Vetch, raised beds and furrows planted with hairy vetch seed (Vicia villosa). Evaluations were conducted using measured pesticide concentrations in runoff at the edge-of-field and estimated environmental concentrations in an adjacent creek and a theoretical pond receiving the runoff. Runoff from Poly-Bare presented the greatest risk to ecosystem health and to sensitive organisms, whereas the use of Vetch minimized these risks. Previous studies have shown that harvest yields were maintained and that runoff volume, soil loss, and off-site transport of pesticides measured in runoff were reduced using the alternative management practices (Poly-Rye and Vetch). Together, these results indicate that the alternative management practices (Poly-Rye and Vetch) have a less adverse impact on the environment than the conventional management practice (Poly-Bare) while providing growers with an acceptable economic return. In addition, the present study demonstrates the need to consider the management practice when assessing the potential risks and hazards for certain pesticides. PMID:17941735

  18. Nutrition and feed management strategies to reduce nutrient excretions and odors from swine manure.

    PubMed

    Sutton, A L; Richert, B T

    2004-01-01

    Manipulation of the pig's diet to reduce nutrient excretions and odors is feasible and practical. Avoiding excessive dietary protein, using high quality protein sources, and feeding low protein, amino acid supplemented diets are practices that will reduce the N in excreta. Avoiding excessive overages of dietary P, balancing diets on an available P basis, and use of phytase as a dietary supplement offers potential for further reducing the P in manure. Use of reduced or organic forms of Cu, Zn, Fe and Mg will reduce excretion of these nutrients in manure. Feeding management technologies that will enhance feed efficiencies and reduce nutrient excretion include feeding for phase, sex and genetic ability of the animal. Reducing the intact protein levels in diets and balancing with synthetic amino acids, use of low levels of specific non-starch polysaccharides (NSP; soybean hulls, sugar beet pulp), and maintaining the proper acid-base balance and buffering in the diet can significantly reduce odorous compounds. Greater nutrient reductions may be possible through the development of specialty feed ingredients that will be used for specific animal diets. Research to fine-tune the diets for production systems is needed. PMID:15137450

  19. Reducing Patient Clinical Management Errors Using Structured Content and Electronic Nursing Handover.

    PubMed

    Johnson, Maree; Sanchez, Paula; Zheng, Catherine

    2016-01-01

    We examined whether an integrated nursing handover system-structured content and an electronic tool within the patient clinical information system with bedside delivery-would improve the quality of information delivered at nursing handover and reduce adverse patient outcomes. Using a pre/posttest evaluative design, improvements in the transfer of critical patient information and reductions in nursing clinical management incidents were demonstrated. No changes in falls or medication incident rates were identified. PMID:26796972

  20. Working to reduce the effects of discrimination: Identity management strategies in organizations.

    PubMed

    Shih, Margaret; Young, Maia J; Bucher, Amy

    2013-04-01

    Despite efforts to dispel discrimination, workplace discrimination still occurs. We introduce two classes of identity management strategies individuals use to mitigate the negative consequences of discrimination: identity switching (i.e., deemphasizing target identities and recategorizing to a more positively valued identity) and identity redefinition (i.e., stereotype reassociation and regeneration). Organizations adopting a color-blind approach may make it more difficult for individuals to use identity switching because the policies deemphasize differences in social identities. In contrast, organizations adopting a multicultural approach may make it more difficult for individuals to use identity redefinition. Multicultural approaches, applied superficially, may celebrate group differences that might actually reinforce culturally dominant stereotypes. We explore the likelihood that individuals will adopt each strategy given these organizational approaches to diversity. We outline steps organizations can take to reduce the need for identity management strategies and to facilitate identity management when necessary. PMID:23586490

  1. Reducing Health Cost: Health Informatics and Knowledge Management as a Business and Communication Tool

    NASA Astrophysics Data System (ADS)

    Gyampoh-Vidogah, Regina; Moreton, Robert; Sallah, David

    Health informatics has the potential to improve the quality and provision of care while reducing the cost of health care delivery. However, health informatics is often falsely regarded as synonymous with information management (IM). This chapter (i) provides a clear definition and characteristic benefits of health informatics and information management in the context of health care delivery, (ii) identifies and explains the difference between health informatics (HI) and managing knowledge (KM) in relation to informatics business strategy and (iii) elaborates the role of information communication technology (ICT) KM environment. This Chapter further examines how KM can be used to improve health service informatics costs, and identifies the factors that could affect its implementation and explains some of the reasons driving the development of electronic health record systems. This will assist in avoiding higher costs and errors, while promoting the continued industrialisation of KM delivery across health care communities.

  2. Management Strategies Aiming to Improve Horse Welfare Reduce Embryonic Death Rates in Mares.

    PubMed

    Malschitzky, E; Pimentel, A M; Garbade, P; Jobim, Mim; Gregory, R M; Mattos, R C

    2015-08-01

    The objective of this retrospective study was to evaluate the effect of management strategies aiming to improve animal well-being on pregnancy and embryonic death (ED) rates. Breeding records of a cohort of 1206 Thoroughbred mares brought to a stallion station facility, to be bred with the stallions housed there, were evaluated during ten breeding seasons. Mares were blocked according to management strategies in two groups: Stress and Relax. Strategies used to improve animal well-being (Relax group) were as follows: stopping the teasing routine, reducing or eliminating stall confinement, reducing the number of mares per group and maintaining herd stability during the breeding season. In barren mares, the pregnancy rate was higher in the Relax group (91.8%) when compared to the observed in Stress group (84.7%). However, no difference in pregnancy rates were observed (Stress = 85.2% vs. Relax = 86.2) in foaling mares. ED rate was higher in barren and foaling mares of the Stress group mares (25.5% and 26.8%, respectively) compared with the Relax group (16.1% and 14.7%, respectively). No significant differences were observed on foal heat pregnancy rate between groups; yet, the embryo loss on foal heat was significant reduced in Relax mares (Relax = 8.7% vs Stress = 24.5%). In conclusion, management strategies aimed to reduce social stress can reduce early pregnancy losses and the average cycles per pregnancy, improving reproductive performance in mares. PMID:25981406

  3. Can a pain management programme approach reduce healthcare use? Stopping the revolving door.

    PubMed

    Clare, Ajay; Andiappan, Manoharan; MacNeil, Sarah; Bunton, Tamzin; Jarrett, Stephanie

    2013-08-01

    Patients with chronic musculoskeletal pain are frequent users of healthcare. Whilst evidence suggests that a multidisciplinary pain management programme (PMP) approach is effective in reducing patients' levels of distress and disability, there is little research examining the cost-effectiveness of such an approach. The present study sought to address this by examining the impact a PMP had on patients' pain-related secondary care healthcare use. A 90.5% reduction in healthcare use was found 12 months after the PMP, compared with 12 months before the PMP. The cost of the pain-related healthcare use 12 months before the PMP was £35,700. Twelve months after the PMP, the cost of healthcare use had reduced to £3879. The findings suggest that a PMP approach could reduce pain-related healthcare use. PMID:26516513

  4. Increasing value and reducing waste in biomedical research regulation and management

    PubMed Central

    Salman, Rustam Al-Shahi; Beller, Elaine; Kagan, Jonathan; Hemminki, Elina; Phillips, Robert S; Savulescu, Julian; Macleod, Malcolm; Wisely, Janet; Chalmers, Iain

    2014-01-01

    After identification of an important research question and selection of an appropriate study design, waste can arise from the regulation, governance, and management of biomedical research. Obtaining regulatory and governance approval has become increasingly burdensome and disproportionate to the conceivable risks to research participants. Regulation and governance involve interventions that are assumed to be justified in the interests of patients and the public, but they can actually compromise these interests. Inefficient management of the procedural conduct of research is wasteful, especially if it results in poor recruitment and retention of participants in well designed studies addressing important questions. These sources of waste can be minimised if the following four recommendations are addressed. First, regulators should use their influence to reduce other causes of waste and inefficiency in research. Second, regulators and policy makers should work with researchers, patients, and health professionals to streamline and harmonise the laws, regulations, guidelines, and processes that govern whether and how research can be done, and ensure that they are proportionate to the plausible risks associated with the research. Third, researchers and research managers should increase the efficiency of recruitment, retention, data monitoring, and data sharing in research through use of research designs known to reduce inefficiencies, and further research should be done to learn how efficiency can be increased. Finally, everyone, particularly those responsible for health-care systems, should promote integration of research into everyday clinical practice. Regulators and researchers should monitor adherence to each of these recommendations and publish metrics. PMID:24411646

  5. Evaluation of management strategies for reducing nitrogen loadings to four US estuaries.

    PubMed

    Whitall, D; Castro, M; Driscoll, C

    2004-10-15

    In this study we used the Watershed Assessment Tool for Evaluating Reduction Strategies for Nitrogen (WATERSN) model to evaluate a variety of management strategies for reducing nitrogen (N) loads to four US east coast estuaries: Casco Bay, Long Island Sound, Chesapeake Bay and Pamlico Sound. These management strategies encompass reductions in atmospheric emissions and deposition of N from sources including, fossil fuel burning utility emissions and mobile NO(x) emissions, N treatment in wastewater and controls on agricultural N inputs. We find that in primarily urban watersheds biological removal of N in wastewater treatment produces the greatest reduction in N loading (32-57% reductions), while in less urban watersheds, reductions in agricultural loading are more effective (5-56% reductions) in decreasing N loads to coastal ecosystems. Because anthropogenic N inputs are derived from a variety of sources, we also examined an integrated scenario targeting all major N sources; this resulted in 35-58% reductions in N loading. Nitrogen pollution originates from multiple sources and is transported through several media (air, soil, water); a major challenge of the development of N management strategies will be the control of multiple sources to effectively reduce N loads to estuaries. PMID:15364517

  6. Tension between reducing sea-level rise and global warming through solar-radiation management

    NASA Astrophysics Data System (ADS)

    Irvine, P. J.; Sriver, R. L.; Keller, K.

    2012-02-01

    Geoengineering using solar-radiation management (SRM) is gaining interest as a potential strategy to reduce future climate change impacts. Basic physics and past observations suggest that reducing insolation will, on average, cool the Earth. It is uncertain, however, whether SRM can reduce climate change stressors such as sea-level rise or rates of surface air temperature change. Here we use an Earth system model of intermediate complexity to quantify the possible response of sea levels and surface air temperatures to projected climate forcings and SRM strategies. We find that SRM strategies introduce a potentially strong tension between the objectives to reduce (1) the rate of temperature change and (2) sea-level rise. This tension arises primarily because surface air temperatures respond faster to radiative forcings than sea levels. Our results show that the forcing required to stop sea-level rise could cause a rapid cooling with a rate similar to the peak business-as-usual warming rate. Furthermore, termination of SRM was found to produce warming rates up to five times greater than the maximum rates under the business-as-usual CO2 scenario, whereas sea-level rise rates were only 30% higher. Reducing these risks requires a slow phase-out of many decades and thus commits future generations.

  7. Reducing job insecurity and increasing performance ratings: does impression management matter?

    PubMed

    Huang, Guo-hua; Zhao, Helen Hailin; Niu, Xiong-ying; Ashford, Susan J; Lee, Cynthia

    2013-09-01

    Prior research on job insecurity has demonstrated its detrimental effects on both employees and the organization, yet no research has detailed how people actively deal with it. Drawing from proactivity research, this article argues that job insecurity prompts a proactive use of impression management tactics in the workplace. The effectiveness of these tactics depends on the level of supervisory liking for the employee and the attributions supervisors make regarding the employee's motives for the impression management behaviors (i.e., for the good of the organization or for self-interest). A 3-wave survey study of 271 Chinese employees and their supervisors showed that employees experiencing job insecurity in Time 1 reported using a variety of tactics to impress their supervisors at Time 2 and that these tactics curbed the affect associated with job insecurity and enhanced supervisor rated performance, through supervisor's liking and attributed motives. The relationship between impression management and increased supervisor-rated performance was moderated by supervisor attributions; the relationship between impression management and reduced affective job insecurity depended on supervisor liking. PMID:23731028

  8. Waste management options to reduce greenhouse gas emissions from paper in Australia

    NASA Astrophysics Data System (ADS)

    Pickin, J. G.; Yuen, S. T. S.; Hennings, H.

    A lifecycle assessment to estimate greenhouse gas emissions in Australia from the paper cycle is summarised. The greenhouse gas emissions from paper in Australia in 1999/2000 were estimated to be 12.1 million tonnes (Mt) of CO 2 equivalent. Nearly half of this amount consisted of CH 4 emissions from landfilled waste paper. Various waste management options were modelled to investigate the greenhouse impact of a tonne of paper over its whole lifecycle. Options that keep paper out of landfills significantly reduce greenhouse emissions, waste-to-energy recovery being most effective. Recycling is also beneficial, and is of particular interest from a management perspective because it can be controlled by the pulp and paper industry. These findings can be extended to other wood-based and organic wastes.

  9. Data Mining to Improve Management and Reduce Costs Associated With Environmental Remediation

    NASA Astrophysics Data System (ADS)

    Minsker, B. S.; Farrell, D. M.

    2004-12-01

    In this study, data from 105 soil and groundwater remediation projects at BP gas stations were mined for lessons to reduce cost and improve management of remediation sites. A data mining tool called D2K was used to train decision tree, stepwise linear regression and instance based weighting models that relate hydrogeologic, sociopolitical, temporal and remedial factors in the site closure reports to remediation cost. The most important factors influencing cost were found to be the amount of soil excavated and the number of wells installed, suggesting that better management of excavation and well placement could result in significant cost savings. The best model for predicting cost classes (low, medium, and high cost) was the decision tree which had a prediction accuracy of approximately 73%. The misclassification of approximately 27% of the sites in even the best model suggests that remediation costs at service stations are influenced by other site-specific factors that may be difficult to accurately predict in advance.

  10. Nursing students' time management, reducing stress and gaining satisfaction: a grounded theory study.

    PubMed

    Mirzaei, Tayebeh; Oskouie, Fatemeh; Rafii, Forough

    2012-03-01

    In the course of their studies, nursing students must learn many skills and acquire the knowledge required for their future profession. This study investigates how Iranian nursing students manage their time according to the circumstances and obstacles of their academic field. Research was conducted using the grounded theory method. Twenty-one nursing students were purposefully chosen as participants. Data was collected through semi-structured interviews and analyzed using the method suggested by Corbin and Strauss. One of the three processes that the nursing students used was "unidirectional time management." This pattern consists of accepting the nursing field, overcoming uncertainty, assessing conditions, feeling stress, and trying to reduce stress and create satisfaction. It was found that students allotted most of their time to academic tasks in an attempt to overcome their stress. The findings of this study indicate the need for these students to have time for the extra-curricular activities and responsibilities that are appropriate to their age. PMID:22293018

  11. Biochar application reduces N2O emission in intensively managed temperate grassland

    NASA Astrophysics Data System (ADS)

    Felber, R.; Leifeld, J.; Neftel, A.

    2012-04-01

    Biochar, a pyrolysis product of organic residues, is seen as an amendment for agricultural soils to improve soil fertility, sequester CO2 and reduce N2O emissions. Mainly used in highly weathered tropical soils, the interest of using biochar in intensively managed temperate soils is increasing. Our previous laboratory incubations have shown N2O reduction potentials of between 20 and 100% for temperate soils after biochar application (Felber et al., Biogeosciences Discuss, 2012). To assess the effect of biochar application under field conditions, a plot experiment (3 control vs. 3 biochar amended plots of 3x3 m size at a rate of 15 t ha-1) was set up in a temperate intensively managed grassland soil. N2O and CO2 emissions were quasi-continuously measured by static chambers under standard management practice over 8 months. In parallel soil samples were taken monthly from all plots and their N2O and CO2 productions were measured under controlled conditions in the lab. At the beginning of the field measurements (April 2011) cumulative N2O fluxes from biochar amended plots were above those of control plots, but the pattern reversed towards reduced fluxes from biochar plots after 3 months and the reduction reached about 15% by the end of 2011. The biochar effect on reducing N2O emissions in the laboratory was two times that of the field measurements, indicating that results from laboratory experiments are not directly transferable to field conditions. The experiments indicate a substantial N2O emission reduction potential of biochar in temperate grassland fields.

  12. Effectiveness of Print Education at Reducing Urban Mosquito Infestation through Improved Resident-Based Management

    PubMed Central

    Bodner, Danielle; LaDeau, Shannon L.; Biehler, Dawn; Kirchoff, Nicole; Leisnham, Paul T.

    2016-01-01

    Improving resident-based management and knowledge of mosquitoes is often an integral component of integrated mosquito management, especially in urban landscapes with considerable mosquito habitat on privately owned lands. This study tested the effectiveness of print education materials at reducing urban mosquito exposure through improving resident knowledge of, and attitudes towards, mosquitoes and mosquito management in Washington DC, USA. There was a specific focus on the removal of water-filled containers that are utilized by the developmental stages of the two most common vector species in the region, Aedes albopictus and Culex pipiens. Households in six neighborhoods that varied in socio-economic status were administered knowledge, attitude, and practice (KAP) surveys in 2010 and 2012, and had their yards surveyed for container habitats and immature mosquitoes (larvae and pupae) in 2010, 2011, and 2012. Half the households (intervention, n = 120) received education materials in 2011 and 2012 to yield a before-after control-intervention (BACI) design. Unexpectedly, residents in intervention households were more likely to show decreased concern for mosquito-borne illnesses than residents in control households, which did not receive materials. Moreover, there was a greater probability that control households reduced containers in 2012 than intervention households, particularly when they had low numbers of baseline (2010) containers. Irrespective of control, reductions in containers were associated with decreased abundances of immature mosquitoes. Overall, our findings suggest that print education materials may have unintended negative effects on resident attitudes and household management of mosquito production. We recommend that mosquito control agencies need to carefully consider their content of print messages and the effectiveness of strategies that passively convey information with little or no engagement with control professionals. PMID:27171195

  13. Effectiveness of Print Education at Reducing Urban Mosquito Infestation through Improved Resident-Based Management.

    PubMed

    Bodner, Danielle; LaDeau, Shannon L; Biehler, Dawn; Kirchoff, Nicole; Leisnham, Paul T

    2016-01-01

    Improving resident-based management and knowledge of mosquitoes is often an integral component of integrated mosquito management, especially in urban landscapes with considerable mosquito habitat on privately owned lands. This study tested the effectiveness of print education materials at reducing urban mosquito exposure through improving resident knowledge of, and attitudes towards, mosquitoes and mosquito management in Washington DC, USA. There was a specific focus on the removal of water-filled containers that are utilized by the developmental stages of the two most common vector species in the region, Aedes albopictus and Culex pipiens. Households in six neighborhoods that varied in socio-economic status were administered knowledge, attitude, and practice (KAP) surveys in 2010 and 2012, and had their yards surveyed for container habitats and immature mosquitoes (larvae and pupae) in 2010, 2011, and 2012. Half the households (intervention, n = 120) received education materials in 2011 and 2012 to yield a before-after control-intervention (BACI) design. Unexpectedly, residents in intervention households were more likely to show decreased concern for mosquito-borne illnesses than residents in control households, which did not receive materials. Moreover, there was a greater probability that control households reduced containers in 2012 than intervention households, particularly when they had low numbers of baseline (2010) containers. Irrespective of control, reductions in containers were associated with decreased abundances of immature mosquitoes. Overall, our findings suggest that print education materials may have unintended negative effects on resident attitudes and household management of mosquito production. We recommend that mosquito control agencies need to carefully consider their content of print messages and the effectiveness of strategies that passively convey information with little or no engagement with control professionals. PMID:27171195

  14. Wind erosion reduces soil organic carbon sequestration falsely indicating ineffective management practices

    NASA Astrophysics Data System (ADS)

    Chappell, Adrian; Baldock, Jeffrey A.

    2016-09-01

    Improved management of agricultural land has the potential to reduce greenhouse gas emissions and to reduce atmospheric CO2 via soil carbon sequestration. However, SOC stocks are reduced by soil erosion which is commonly omitted from calculations of crop production, C cycling, C sequestration and C accounting. We used fields from the wind eroded dryland cropping region of Western Australia to demonstrate the global implications for C sequestration and C accounting of omitting soil erosion. For the fields we previously estimated mean net (1950s-1990) soil erosion of 1.2 ± 1.0 t ha-1 y-1. The mean net (1990-2013) soil erosion increased by nearly four times to 4.4 ± 2.1 t ha-1 y-1. Conservation agriculture has evidently not reduced wind erosion in this region. The mean net (1990-2013) SOC erosion was up to 0.2 t C ha-1 y-1 across all sampled fields and similar to measured sequestration rates in the region (up to 0.5 t C ha-1 y-1; 10 years) for many management practices recommended for building SOC stocks. The minimum detectable change (MDC; 10 years) of SOC without erosion was up to 0.2 t C ha-1 y-1 whilst the MDC of SOC with erosion was up to 0.4 t C ha-1 y-1. These results illustrate the generally applicable outcome: (i) if SOC erosion is equal to (or greater than) the increase in SOC due to management practices, the change will not be detectable (or a loss will be evident); (ii) without including soil erosion in SOC sequestration calculations, the monitoring of SOC stocks will lead to, at best the inability to detect change and, at worst the false impression that management practices have failed to store SOC. Furthermore, continued omission of soil erosion in crop production, C accounting and C sequestration will most likely undermine confidence in policy designed to encourage adoption of C farming and the attendant benefits for soil stewardship and food security.

  15. Damage-reducing measures to manage flood risks in a changing climate

    NASA Astrophysics Data System (ADS)

    Kreibich, Heidi; Bubeck, Philip; Van Vliet, Mathijs; De Moel, Hans

    2014-05-01

    Damage due to floods has increased during the last few decades, and further increases are expected in several regions due to climate change and a growing vulnerability. To address the projected increase in flood risk, a combination of structural and non-structural flood risk mitigation measures is considered as a promising adaptation strategy. Such a combination takes into account that flood defence systems may fail, and prepare for unexpected crisis situations via land-use planning, building construction, evacuation and disaster response. Non-structural flood risk mitigation measures like shielding with water shutters or sand bags, building fortification or safeguarding of hazardous substances are often voluntary: they demand self-dependent action by the population at risk (Bubeck et al. 2012; 2013). It is believed that these measures are especially effective in areas with frequent flood events and low flood water levels, but some types of measures showed a significant damage-reducing effect also during extreme flood events, such as the Elbe River flood in August 2002 in Germany (Kreibich et al. 2005; 2011). Despite the growing importance of damage-reducing measures, information is still scarce about factors that motivate people to undertake such measures, the state of implementation of various non-structural measures in different countries and their damage reducing effects. Thus, we collected information and undertook an international review about this topic in the framework of the Dutch KfC project "Climate proof flood risk management". The contribution will present an overview about the available information on damage-reducing measures and draw conclusions for practical flood risk management in a changing climate. References: Bubeck, P., Botzen, W. J. W., Suu, L. T. T., Aerts, J. C. J. H. (2012): Do flood risk perceptions provide useful insights for flood risk management? Findings from central Vietnam. Journal of Flood Risk Management, 5, 4, 295-302 Bubeck, P

  16. DEVELOPMENT OF A BRIEF SUBSTANCE USE SENSATION SEEKING SCALE: VALIDATION AND PREDICTION OF INJECTION-RELATED BEHAVIORS

    PubMed Central

    Werb, Dan; Richardson, Chris; Buxton, Jane; Shoveller, Jeannie; Wood, Evan; Kerr, Thomas

    2015-01-01

    Sensation seeking, a personality trait, has been shown to predict engagement in high-risk behaviors. However, little is known regarding the impact of sensation seeking on substance use among street youth. We therefore sought to modify a sensation seeking scale (SSS) for use among this population. Street youth from the Vancouver-based At-Risk Youth Study (n = 226) completed the modified SSS. Exploratory and confirmatory factor analysis (EFA/CFA) were undertaken to establish the scale’s dimensionality and internal validity. The association between SSS score and injection-related behaviors was tested using generalized estimating equation (GEE) analysis. EFA results indicated scale unidimensionality. The comparative fit index (CFI) suggested acceptable fit (CFI = 0.914). In multivariate analysis, sensation seeking was independently associated with injection drug use, crystal methamphetamine use, polysubstance use, and binge drug use (all p < 0.05). Our findings provide preliminary support for the use of the modified SSS among street youth. PMID:25119056

  17. Incentivizing the public to support invasive species management: eurasian milfoil reduces lakefront property values.

    PubMed

    Olden, Julian D; Tamayo, Mariana

    2014-01-01

    Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995-2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management. PMID:25333619

  18. Incentivizing the Public to Support Invasive Species Management: Eurasian Milfoil Reduces Lakefront Property Values

    PubMed Central

    Olden, Julian D.; Tamayo, Mariana

    2014-01-01

    Economic evaluations of invasive species are essential for providing comprehensive assessments of the benefits and costs of publicly-funded management activities, yet many previous investigations have focused narrowly on expenditures to control spread and infestation. We use hedonic modeling to evaluate the economic effects of Eurasian milfoil (Myriophyllum spicatum) invasions on lakefront property values of single-family homes in an urban-suburban landscape. Milfoil often forms dense canopies at the water surface, diminishing the value of ecosystem services (e.g., recreation, fishing) and necessitating expensive control and management efforts. We compare 1,258 lakeshore property sale transactions (1995–2006) in 17 lakes with milfoil and 24 un-invaded lakes in King County, Washington (USA). After accounting for structural (e.g., house size), locational (e.g., boat launch), and environmental characteristics (e.g., water clarity) of lakes, we found that milfoil has a significant negative effect on property sales price ($94,385 USD lower price), corresponding to a 19% decline in mean property values. The aggregate cost of milfoil invading one additional lake in the study area is, on average, $377,542 USD per year. Our study illustrates that invasive aquatic plants can significantly impact property values (and associated losses in property taxes that reduce local government revenue), justifying the need for management strategies that prevent and control invasions. We recommend coordinated efforts across Lake Management Districts to focus institutional support, funding, and outreach to prevent the introduction and spread of milfoil. This effort will limit opportunities for re-introduction from neighboring lakes and incentivize private landowners and natural resource agencies to commit time and funding to invasive species management. PMID:25333619

  19. Reducing nitrogen loss with managed drainage and polymer-coated urea.

    PubMed

    Nash, Patrick; Nelson, Kelly; Motavalli, Peter

    2015-01-01

    Continuous corn ( L.) production during dry years combined with high N fertilizer rates can have a high potential for NO-N loss through tile drainage water. Claypan soils can further increase the potential for NO-N loss through tile drainage water due to the claypan layer that restricts N leaching below the tile drains. The objective of this 4-yr study was to determine whether use of managed subsurface drainage (MD) in combination with a controlled-release N fertilizer could reduce the annual amount of NO-N loss through tile drainage water compared with free subsurface tile drainage (FD) with a noncoated urea application. Due to dry conditions over the summer and fall months, MD reduced the annual amount of water drained by at least 73% compared with FD in two of the four crop years. Low N loss and reduced corn N uptake possibly resulted in carry-over N and high soil N concentrations throughout the study, which may have limited the effect of N fertilizer source on annual NO-N loss in the tile drainage water. Use of MD reduced annual NO-N loss in the tile drainage water by 78 to 85% in two of the four years. High NO-N loss reduction with MD compared with FD was largely due to dry growing season conditions in combination with wet conditions over the noncropping period. PMID:25602341

  20. Waste Management Strategy for Dismantling Waste to Reduce Costs for Power Plant Decommissioning - 13543

    SciTech Connect

    Larsson, Arne; Lidar, Per; Bergh, Niklas; Hedin, Gunnar

    2013-07-01

    -necks in the process causes increased space requirements and will have negative impact on the project schedule, which increases not only the cost but also the dose exposure to personnel. For these reasons it is critical to create a process that transfers material into conditioned waste ready for disposal as quickly as possible. To a certain extent the decommissioning program should be led by the waste management process. With the objective to reduce time for handling of dismantled material at site and to efficiently and environmental-friendly use waste management methods (clearance for re-use followed by clearance for recycling), the costs for the plant decommissioning could be reduced as well as time needed for performing the decommissioning project. Also, risks for delays would be reduced with a well-defined handling scheme which limits surprises. Delays are a major cost driver for decommissioning projects. (authors)

  1. Managing Overweight and Obesity in Adults to Reduce Cardiovascular Disease Risk

    PubMed Central

    Ebbert, Jon O.; Elrashidi, Muhamad Y.

    2014-01-01

    Obesity is a leading preventable cause of death and disability worldwide. Obesity increases the risk for clinically identifiable risk factors for cardiovascular disease (CVD) as well as a host of other metabolic, sleep, and orthopedic disorders. Coordinated and systematic interventions are needed to manage obesity and reduce these risks. The Obesity 2 Expert Panel updated previous guidelines and produced the “Guideline for the Management of Overweight and Obesity in Adults.” The Panel used data from publications from years 1999 to 2011 to address five critical questions, provide evidence statements, and recommend creation of a treatment algorithm to guide decision making about clinical care. The current review discusses the evidence statements pertaining to CVD risk in the assessment and management of patients who are overweight and obese. We summarize the FDA-approved medications for the treatment of overweight and obesity and their impact on CVD risk and risk factors, as well as ongoing clinical trials which will further inform clinical practice. PMID:25092581

  2. Effectiveness of managed gene flow in reducing genetic divergence associated with captive breeding.

    PubMed

    Waters, Charles D; Hard, Jeffrey J; Brieuc, Marine S O; Fast, David E; Warheit, Kenneth I; Waples, Robin S; Knudsen, Curtis M; Bosch, William J; Naish, Kerry A

    2015-12-01

    Captive breeding has the potential to rebuild depressed populations. However, associated genetic changes may decrease restoration success and negatively affect the adaptive potential of the entire population. Thus, approaches that minimize genetic risks should be tested in a comparative framework over multiple generations. Genetic diversity in two captive-reared lines of a species of conservation interest, Chinook salmon (Oncorhynchus tshawytscha), was surveyed across three generations using genome-wide approaches. Genetic divergence from the source population was minimal in an integrated line, which implemented managed gene flow by using only naturally-born adults as captive broodstock, but significant in a segregated line, which bred only captive-origin individuals. Estimates of effective number of breeders revealed that the rapid divergence observed in the latter was largely attributable to genetic drift. Three independent tests for signatures of adaptive divergence also identified temporal change within the segregated line, possibly indicating domestication selection. The results empirically demonstrate that using managed gene flow for propagating a captive-reared population reduces genetic divergence over the short term compared to one that relies solely on captive-origin parents. These findings complement existing studies of captive breeding, which typically focus on a single management strategy and examine the fitness of one or two generations. PMID:26640521

  3. Effectiveness of managed gene flow in reducing genetic divergence associated with captive breeding

    PubMed Central

    Waters, Charles D; Hard, Jeffrey J; Brieuc, Marine S O; Fast, David E; Warheit, Kenneth I; Waples, Robin S; Knudsen, Curtis M; Bosch, William J; Naish, Kerry A

    2015-01-01

    Captive breeding has the potential to rebuild depressed populations. However, associated genetic changes may decrease restoration success and negatively affect the adaptive potential of the entire population. Thus, approaches that minimize genetic risks should be tested in a comparative framework over multiple generations. Genetic diversity in two captive-reared lines of a species of conservation interest, Chinook salmon (Oncorhynchus tshawytscha), was surveyed across three generations using genome-wide approaches. Genetic divergence from the source population was minimal in an integrated line, which implemented managed gene flow by using only naturally-born adults as captive broodstock, but significant in a segregated line, which bred only captive-origin individuals. Estimates of effective number of breeders revealed that the rapid divergence observed in the latter was largely attributable to genetic drift. Three independent tests for signatures of adaptive divergence also identified temporal change within the segregated line, possibly indicating domestication selection. The results empirically demonstrate that using managed gene flow for propagating a captive-reared population reduces genetic divergence over the short term compared to one that relies solely on captive-origin parents. These findings complement existing studies of captive breeding, which typically focus on a single management strategy and examine the fitness of one or two generations. PMID:26640521

  4. Identification and prioritization of management practices to reduce methylmercury exports from wetlands and irrigated agricultural lands.

    PubMed

    McCord, Stephen A; Heim, Wesley A

    2015-03-01

    The Sacramento-San Joaquin Delta's (Delta) beneficial uses for humans and wildlife are impaired by elevated methylmercury (MeHg) concentrations in fish. MeHg is a neurotoxin that bioaccumulates in aquatic food webs. The total maximum daily load (TMDL) implementation plan aimed at reducing MeHg in Delta fish obligates dischargers to conduct MeHg control studies. Over 150 stakeholders collaborated to identify 24 management practices (MPs) addressing MeHg nonpoint sources (NPS) in three categories: biogeochemistry (6), hydrology (14), and soil/vegetation (4). Land uses were divided into six categories: permanently and seasonally flooded wetlands, flooded and irrigated agricultural lands, floodplains, and brackish-fresh tidal marshes. Stakeholders scored MPs based on seven criteria: scientific certainty, costs, MeHg reduction potential, spatial applicability, technical capacity to implement, negative impacts to beneficial uses, and conflicting requirements. Semi-quantitative scoring for MPs applicable to each land use (totaling >400 individual scores) led to consensus-based prioritization. This process relied on practical experience from diverse and accomplished NPS stakeholders and synthesis of 17 previous studies. Results provide a comprehensive, stakeholder-driven prioritization of MPs for wetland and irrigated agricultural land managers. Final prioritization highlights the most promising MPs for practical application and control study, and a secondary set of MPs warranting further evaluation. MPs that address hydrology and soil/vegetation were prioritized because experiences were positive and implementation appeared more feasible. MeHg control studies will need to address the TMDL conundrum that MPs effective at reducing MeHg exports could both exacerbate MeHg exposure and contend with other management objectives on site. PMID:25566831

  5. Identification and Prioritization of Management Practices to Reduce Methylmercury Exports from Wetlands and Irrigated Agricultural Lands

    NASA Astrophysics Data System (ADS)

    McCord, Stephen A.; Heim, Wesley A.

    2015-03-01

    The Sacramento-San Joaquin Delta's (Delta) beneficial uses for humans and wildlife are impaired by elevated methylmercury (MeHg) concentrations in fish. MeHg is a neurotoxin that bioaccumulates in aquatic food webs. The total maximum daily load (TMDL) implementation plan aimed at reducing MeHg in Delta fish obligates dischargers to conduct MeHg control studies. Over 150 stakeholders collaborated to identify 24 management practices (MPs) addressing MeHg nonpoint sources (NPS) in three categories: biogeochemistry (6), hydrology (14), and soil/vegetation (4). Land uses were divided into six categories: permanently and seasonally flooded wetlands, flooded and irrigated agricultural lands, floodplains, and brackish-fresh tidal marshes. Stakeholders scored MPs based on seven criteria: scientific certainty, costs, MeHg reduction potential, spatial applicability, technical capacity to implement, negative impacts to beneficial uses, and conflicting requirements. Semi-quantitative scoring for MPs applicable to each land use (totaling >400 individual scores) led to consensus-based prioritization. This process relied on practical experience from diverse and accomplished NPS stakeholders and synthesis of 17 previous studies. Results provide a comprehensive, stakeholder-driven prioritization of MPs for wetland and irrigated agricultural land managers. Final prioritization highlights the most promising MPs for practical application and control study, and a secondary set of MPs warranting further evaluation. MPs that address hydrology and soil/vegetation were prioritized because experiences were positive and implementation appeared more feasible. MeHg control studies will need to address the TMDL conundrum that MPs effective at reducing MeHg exports could both exacerbate MeHg exposure and contend with other management objectives on site.

  6. Nurse Case Management and Housing Interventions Reduce Allergen Exposures: The Milwaukee Randomized Controlled Trial

    PubMed Central

    Breysse, Jill; Wendt, Jean; Dixon, Sherry; Murphy, Amy; Wilson, Jonathan; Meurer, John; Cohn, Jennifer; Jacobs, David E.

    2011-01-01

    Objective We examined the impact of a combination of home environmental interventions and nurse case management services on total settled dust loadings and on allergen concentrations in the homes of asthmatic children. Methods Using a randomized longitudinal controlled trial study design, we randomly assigned homes of asthmatic children in Milwaukee to either a control (n=64) or an intervention (n=57) group. Control group homes received a visual assessment, education, bed/pillow dust mite encasings, and treatment of lead-based paint hazards. The intervention group received these same services plus nurse case management that included tailored, individual asthma action plans, provision of minor home repairs, home cleaning using special vacuuming and wet washing, and integrated pest management. Dust vacuum samples were collected from measured surface areas of floors in the TV room, kitchen, and child's bedroom at baseline and at three-, six-, and 12-month follow-up visits. Dust loading (mass per surface area) is a means of measuring total dust and the total amount of allergen present. Results For the intervention group, geometric mean dust loadings declined significantly from baseline (39 milligrams per square foot [mg/ft2]) to post-intervention (11 mg/ft2) (p<0.001). Baseline dust loading, treatment group, visit, and season were significant predictors of follow-up dust loadings. Mean post-intervention dust loadings were 72% higher in the control group. The total amount of allergen in settled house dust declined significantly following the intervention because total dust loading declined; the concentration of allergens in settled dust did not change significantly. Conclusion The combination of nurse case management and home environmental interventions promotes collaboration between health and housing professionals and is effective in reducing exposures to allergens in settled dust. PMID:21563716

  7. Nurse-led risk assessment/management clinics reduce predicted cardiac morbidity and mortality in claudicants.

    PubMed

    Hatfield, Josephine; Gulati, Sumit; Abdul Rahman, Morhisham N A; Coughlin, Patrick A; Chetter, Ian C

    2008-12-01

    Nurse-led assessment/management of risk factors is effective in many chronic medical conditions. We aimed to evaluate whether this finding was true for patients with intermittent claudication and to analyze its impact on patient-reported quality of life and predicted mortality due to coronary heart disease. We prospectively studied a series of 78 patients (51 men; median age, 65 years [IQR: 56-74 years]), diagnosed with intermittent claudication and referred to a nurse-led risk assessment/management clinic (NLC) from a consultant-led vascular surgical clinic. The NLC used clinical care pathways to manage antiplatelet medication, smoking cessation, hyperlipidemia, hypertension, and diabetes and to provide exercise advice. All patients were reassessed at a 3 months. Medication compliance, smoking status, fasting lipid profiles, blood pressure, and HbA1c were recorded. Disease-specific quality of life was assessed using King's College VascuQoL and predicted cardiac morbidity and mortality were calculated using the PROCAM and Framingham risk scores. We found that NLC enrollment produced an antiplatelet and a statin compliance of 100%, a smoking cessation rate of 17% (9 patients) and significant improvements in total cholesterol (median, 5.2-4.5 mmol/l), LDL (median, 3.1-2.5 mmol/l) and triglyceride (median, 1.7-1.4 mmol/l) levels. Significant disease-specific quality of life improvements and significant reduction in both the PROCAM (14% to 10%) and Framingham (14% to 11%) coronary risk scores were observed. Providing care at NLCs for claudicants is effective in assessing and managing risk factors, improves disease-specific quality of life and reduces predicted morbidity and mortality due to coronary heart disease. PMID:19022170

  8. Reducing Overheating-Induced Failures Via Performance-Aware CPU Power Management.

    SciTech Connect

    Hsu, C.-H.; Feng, W. C.

    2005-01-01

    Cluster end-users and administrators have become more cognizant of the fact that large-scale commodity clusters fail quite frequently, and the main source of these failures is hardware (e.g., processors) with the primary cause being heat. This situation is expected to worsen with even larger-scale clusters powered by faster (and/or multicore) processors. In this paper, we propose a power-management algorithm that addresses heat-related reliability for processors by controlling their clock speeds in a performance-aware manner. This approach is complementary to existing approaches such as exotic cooling and fault-tolerant technologies in that it proactively deals with power and cooling issues before they become a problem. Our preliminary experimental work demonstrates that our approach can easily be applied commodity processors and can reduce heat generation by 30% on average with minimal effect on performance when running the SPEC benchmarks.

  9. Can Artificial Reef Wrecks Reduce Diver Impacts on Shipwrecks? The Management Dimension

    NASA Astrophysics Data System (ADS)

    Edney, Joanne; Spennemann, Dirk H. R.

    2015-08-01

    Managers have been advocating the use of artificial reef wrecks to diversify the experiences of recreational divers and thereby reduce the well-known impact on reefs. To examine whether artificial reef wrecks can serve as substitutes for historic shipwrecks this paper discusses the attitude of Australian divers to wreck diving in general and to artificial reef wrecks in particular. While the overwhelming majority of divers surveyed accepted the need for control, the experienced divers were less interested in artificial reef wrecks and less prepared to tolerate controls over their perceived freedom to dive wrecks. We present projections that show that this legacy issue will have largely resolved itself by 2025 due to attrition and natural ageing.

  10. Managing sedentary behavior to reduce the risk of diabetes and cardiovascular disease.

    PubMed

    Dempsey, Paddy C; Owen, Neville; Biddle, Stuart J H; Dunstan, David W

    2014-01-01

    Modern human environments are vastly different from those of our forebears. Rapidly advancing technology in transportation, communications, workplaces, and home entertainment confer a wealth of benefits, but increasingly come with costs to human health. Sedentary behavior-too much sitting as distinct from too little physical activity-contributes adversely to cardiometabolic health outcomes and premature mortality. Findings from observational epidemiology have been synthesized in meta-analyses, and evidence is now shifting into the realm of experimental trials with the aim of identifying novel mechanisms and potential causal relationships. We discuss recent observational and experimental evidence that makes a compelling case for reducing and breaking up prolonged sitting time in both the primary prevention and disease management contexts. We also highlight future research needs, the opportunities for developing targeted interventions, and the potential of population-wide initiatives designed to address too much sitting as a health risk. PMID:25052856

  11. Reduced Transfusion During OLT by POC Coagulation Management and TEG Functional Fibrinogen: A Retrospective Observational Study

    PubMed Central

    De Pietri, Lesley; Ragusa, Francesca; Deleuterio, Annalisa; Begliomini, Bruno; Serra, Valentina

    2016-01-01

    Background Patients undergoing orthotopic liver transplantation are at high risk of bleeding complications. Several Authors have shown that thromboelastography (TEG)-based coagulation management and the administration of fibrinogen concentrate reduce the need for blood transfusion. Methods We conducted a single-center, retrospective cohort observational study (Modena Polyclinic, Italy) on 386 consecutive patients undergoing liver transplantation. We assessed the impact on resource consumption and patient survival after the introduction of a new TEG-based transfusion algorithm, requiring also the introduction of the fibrinogen functional thromboelastography test and a maximum amplitude of functional fibrinogen thromboelastography transfusion cutoff (7 mm) to direct in administering fibrinogen (2012-2014, n = 118) compared with a purely TEG-based algorithm previously used (2005-2011, n = 268). Results After 2012, there was a significant decrease in the use of homologous blood (1502 ± 1376 vs 794 ± 717 mL, P < 0.001), fresh frozen plasma (537 ± 798 vs 98 ± 375 mL, P < 0.001), and platelets (158 ± 280 vs 75 ± 148 mL, P < 0.005), whereas the use of fibrinogen increased (0.1 ± 0.5 vs 1.4 ± 1.8 g, P < 0.001). There were no significant differences in 30-day and 6-month survival between the 2 groups. Conclusions The implementation of a new coagulation management method featuring the addition of the fibrinogen functional thromboelastography test to the TEG test according to an algorithm which provides for the administration of fibrinogen has helped in reducing the need for transfusion in patients undergoing liver transplantation with no impact on their survival. PMID:27500243

  12. Improving Learning Results and Reducing Cognitive Load through 3D Courseware on Color Management and Inspection Instruction

    ERIC Educational Resources Information Center

    Hsiung, Liang-Yuan; Lai, Mu-Hui

    2013-01-01

    This study intends to solve the problem that schools in Taiwan lack of the equipment for color management and inspection instruction and seek ways to improve learning results and reduce cognitive load. The researchers developed 3D courseware for color management and inspection through a research and development process. To further scrutinize the…

  13. Reducing greenhouse gas emissions through strategic management of highway pavement roughness

    NASA Astrophysics Data System (ADS)

    Wang, Ting; Harvey, John; Kendall, Alissa

    2014-03-01

    On-road vehicle use is responsible for about a quarter of US annual greenhouse gas (GHG) emissions. Changes in vehicles, travel behavior and fuel are likely required to meet long-term climate change mitigation goals, but may require a long time horizon to deploy. This research examines a near-term opportunity: management of pavement network roughness. Maintenance and rehabilitation treatments can make pavements smoother and reduce vehicle rolling resistance. However, these treatments require material production and equipment operation, thus requiring a life cycle perspective for benefits analysis. They must also be considered in terms of their cost-effectiveness in comparison with other alternatives for affecting climate change. This letter describes a life cycle approach to assess changes in total GHG (measured in CO2-e) emissions from strategic management of highway pavement roughness. Roughness values for triggering treatments are developed to minimize GHG considering both treatment and use phase vehicle emission. With optimal triggering for GHG minimization, annualized reductions on the California state highway network over a 10-year analysis period are calculated to be 0.82, 0.57 and 1.38 million metric tons compared with historical trigger values, recently implemented values and no strategic intervention (reactive maintenance), respectively. Abatement costs calculated using /metric-ton CO2-e are higher than those reported for other transportation sector abatement measures, however, without considering all benefits associated with pavement smoothness, such as vehicle life and maintenance, or the time needed for deployment.

  14. Social risk management--reducing disparities in risk, vulnerability and poverty equitably.

    PubMed

    Ruger, Jennifer Prah

    2008-03-01

    Hurricane Katrina, which struck the Gulf Coast on August 29, 2005 and took 1,000 lives or more, was the third deadliest storm to hit the United States, falling behind only the Galveston Hurricane of 1900 and the 1928 Okeechobee Hurricane. It is New Orleans' worst natural disaster in its nearly 300-year history. The storm left hundreds of thousands without access to shelter, food, water, clothing and basic sanitation. The human suffering and health consequences are immeasurable. Dissatisfaction with the federal, national and local governments' planning and response is widespread. Many believe that the system discriminated cruelly by race and class against those in greatest need. The storm revealed serious flaws in disaster relief and preparedness structures, which require major reform. As an alternative, this article proposes a social risk management system to provide both universal risk protection and an efficient, more equitable approach to managing and reducing disparities in vulnerability. While one must realize that incremental rather than comprehensive reform of the system is most likely and most politically feasible, Katrina's horrific consequences and revealed inequities necessitate an alternative model. PMID:18592885

  15. Surveillance recommendations in reducing risk of and optimally managing breast cancer-related lymphedema.

    PubMed

    Ostby, Pamela L; Armer, Jane M; Dale, Paul S; Van Loo, Margaret J; Wilbanks, Cassie L; Stewart, Bob R

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

  16. Surveillance Recommendations in Reducing Risk of and Optimally Managing Breast Cancer-Related Lymphedema

    PubMed Central

    Ostby, Pamela L.; Armer, Jane M.; Dale, Paul S.; Van Loo, Margaret J.; Wilbanks, Cassie L.; Stewart, Bob R.

    2014-01-01

    Breast cancer survivors are at increased risk for the development of breast cancer-related lymphedema (BCRL), a chronic, debilitating, and disfiguring condition that is progressive and requires lifelong self-management of symptoms. It has been reported that over 40% of the 2.5 million breast cancer survivors in the United States may meet the criteria for BCRL during their lifetimes. Ongoing surveillance, beginning with pre-operative assessment, has been effective in identifying subclinical lymphedema (LE). A prospective model for surveillance is necessary in order to detect BCRL at an early stage when there is the best chance to reduce risk or slow progression. Physical methods for monitoring and assessment, such as circumferential arm measures, perometry, bioimpedance; exercise programs; prophylactic and early-intervention compression garments; and referral for complete decongestive therapy are all interventions to consider in the development of a BCRL surveillance program. In addition, supportive-educative programs and interactive engagement for symptom self-management should also be implemented. The importance of interdisciplinary collaboration is integral to the success of an effective personalized medicine program in breast cancer-related lymphedema surveillance. PMID:25563360

  17. Development of a brief substance use sensation seeking scale: validation and prediction of injection-related behaviors.

    PubMed

    Werb, Dan; Richardson, Chris; Buxton, Jane; Shoveller, Jeannie; Wood, Evan; Kerr, Thomas

    2015-02-01

    Sensation seeking, a personality trait, has been shown to predict engagement in high-risk behaviors. However, little is known regarding the impact of sensation seeking on substance use among street youth. We therefore sought to modify a sensation seeking scale (SSS) for use among this population. Street youth from the Vancouver-based At-Risk Youth Study (n = 226) completed the modified SSS. Exploratory and confirmatory factor analysis (EFA/CFA) were undertaken to establish the scale's dimensionality and internal validity. The association between SSS score and injection-related behaviors was tested using generalized estimating equation analysis. EFA results indicated scale unidimensionality. The comparative fit index (CFI) suggested acceptable fit (CFI = 0.914). In multivariate analysis, sensation seeking was independently associated with injection drug use, crystal methamphetamine use, polysubstance use, and binge drug use (all p < 0.05). Our findings provide preliminary support for the use of the modified SSS among street youth. PMID:25119056

  18. Improving water management practices to reduce nutrient export from rice paddy fields.

    PubMed

    Zhang, Zhi-Jian; Yao, Ju-Xiang; Wang, Zhao-De; Xu, Xin; Lin, Xian-Yong; Czapar, George F; Zhang, Jian-Ying

    2011-01-01

    Nitrogen (N) and phosphorus (P) loss from rice paddy fields represents a significant threat to water quality in China. In this project, three irrigation-drainage regimes were compared, including one conventional irrigation-drainage regime, i.e. continuous submergence regime (CSR), and two improved regimes, i.e. the alternating submergence-nonsubmergence regime (ASNR) and the zero-drainage irrigation technology (ZDIT), to seek cost-effective practices for reducing nutrient loss. The data from these comparisons showed that, excluding the nutrient input from irrigation, the net exports of total N and total P via surface field drainage ranged from -3.93 to 2.39 kg ha and 0.17 to 0.95 g ha(-1) under the CSR operation, respectively, while N loss was -2.46 to -2.23 kg ha(-1) and P export was -0.65 to 0.31 kg ha(-1) under the improved regimes. The intensity of P export was positively correlated to the rate of P application. Reducing the draining frequency or postponing the draining operation would shift the ecological role of the paddy field from a nutrient export source to an interception sink when ASNR or the zero-drainage water management was used. In addition, since the rice yields are being guaranteed at no additional cost, the improved irrigation-drainage operations would have economic as well as environmental benefits. PMID:21473282

  19. Reducing surgery in management of spontaneous abortions. Family physicians can make a difference.

    PubMed Central

    Wiebe, E.; Janssen, P.

    1999-01-01

    OBJECTIVE: To test the effectiveness of physician and patient education in reducing the rate of surgery in management of spontaneous abortions in family practice. DESIGN: A before-after intervention trial. SETTING: Urban and suburban family doctors' practices in greater Vancouver, BC. PARTICIPANTS: Family practice patients (56 physicians contributed 417 patients) who had spontaneous abortions between June 1997 and August 1998. INTERVENTIONS: Seminars for doctors and educational pamphlets for patients. MAIN OUTCOME MEASURES: Rate of surgeries, and rates of referrals and complications. RESULTS: In the 2 years before the intervention, the rate of surgery was 45.8% (n = 299); after, it was 32.2% (n = 118). No transfusions were required. Before the intervention, 17% of women had hemorrhages; after, 13%. Rates of infection were 3.7% and 0.8%, respectively. Rates of referral to gynecologists were 54.0% and 40.2%, respectively. CONCLUSIONS: Patients of family doctors who attended seminars and agreed to join the study had significantly reduced rates of surgery after spontaneous abortions. Rates of referral for these patients were also lower, and there was no increase in complications. PMID:10540696

  20. Water cycle and its management for plant habitats at reduced pressures

    NASA Technical Reports Server (NTRS)

    Rygalov, Vadim Y.; Fowler, Philip A.; Wheeler, Raymond M.; Bucklin, Ray A.

    2004-01-01

    Experimental and mathematical models were developed for describing and testing temperature and humidity parameters for plant production in bioregenerative life support systems. A factor was included for analyzing systems operating at low (10-101.3 kPa) pressure to reduce gas leakage and structural mass (e.g., inflatable greenhouses for space application). The expected close relationship between temperature and relative humidity was observed, along with the importance of heat exchanger coil temperature and air circulation rate. The presence of plants in closed habitats results in increased water flux through the system. Changes in pressure affect gas diffusion rates and surface boundary layers, and change convective transfer capabilities and water evaporation rates. A consistent observation from studies with plants at reduced pressures is increased evapotranspiration rates, even at constant vapor pressure deficits. This suggests that plant water status is a critical factor for managing low-pressure production systems. The approach suggested should help space mission planners design artificial environments in closed habitats.

  1. Reducing soil erosion and nutrient loss on sloping land under crop-mulberry management system.

    PubMed

    Fan, Fangling; Xie, Deti; Wei, Chaofu; Ni, Jiupai; Yang, John; Tang, Zhenya; Zhou, Chuan

    2015-09-01

    Sloping croplands could result in soil erosion, which leads to non-point source pollution of the aquatic system in the Three Gorges Reservoir Region. Mulberry, a commonly grown cash plant in the region, is traditionally planted in contour hedgerows as an effective management practice to control soil erosion and non-point source pollution. In this field study, surface runoff and soil N and P loss on sloping land under crop-mulberry management were investigated. The experiments consisted of six crop-mulberry treatments: Control (no mulberry hedgerow with mustard-corn rotation); T1 (two-row contour mulberry with mustard-corn rotation); T2 (three-row contour mulberry with mustard-corn rotation); T3 (border mulberry and one-row contour mulberry with mustard-corn rotation); T4 (border mulberry with mustard-corn rotation); T5 (two-row longitudinal mulberry with mustard). The results indicated that crop-mulberry systems could effectively reduce surface runoff and soil and nutrient loss from arable slope land. Surface runoff from T1 (342.13 m(3) hm(-2)), T2 (260.6 m(3) hm(-2)), T3 (113.13 m(3) hm(-2)), T4 (114 m(3) hm(-2)), and T5 (129 m(3) hm(-2)) was reduced by 15.4, 35.6, 72.0, 71.8, and 68.1%, respectively, while soil loss from T1 (0.21 t hm(-2)), T2 (0.13 t hm(-2)), T3 (0.08 t hm(-2)), T4 (0.11 t hm(-2)), and T5 (0.12 t hm(-2)) was reduced by 52.3, 70.5, 81.8, 75.0, and 72.7%, respectively, as compared with the control. Crop-mulberry ecosystem would also elevate soil N by 22.3% and soil P by 57.4%, and soil nutrient status was contour-line dependent. PMID:25957753

  2. Implications of chronic wasting disease, cougar predation, and reduced recruitment for elk management

    USGS Publications Warehouse

    Sargeant, G.A.; Weber, D.C.; Roddy, D.E.

    2011-01-01

    Emerging diseases and expanding carnivore populations may have profound implications for ungulate harvest management and population regulation. To better understand effects of chronic wasting disease (CWD) and cougar (Puma concolor) predation, we studied mortality and recruitment of elk (Cervus elaphus) at Wind Cave National Park (WICA) during 2005-2009. We marked 202 elk (83 subadult M and 119 subadult and ad F) with Global Positioning System (GPS) collars, observed 28 deaths during 74,220 days of monitoring, and investigated 42 additional deaths of unmarked elk found dead. Survival rates were similar for males and females and averaged 0.863 (SE = 0.025) annually. Leading causes of mortality included hunting (0.065, SE = 0.019), CWD (0.034, SE = 0.012), and cougar predation (0.029, SE = 0.012). Marked elk killed by hunters and cougars typically were in good physical condition and not infected with CWD. Effects of mortality on population growth were exacerbated by low rates of pregnancy (subadults = 9.5%, SE = 6.6%; ad = 76.9%, SE = 4.2%) and perinatal survival (0.49, SE = 0.085 from 1 Feb to 1 Sep). Chronic wasting disease, increased predation, and reduced recruitment reduced the rate of increase for elk at WICA to approximately ?? = 1.00 (SE = 0.027) during the past decade. Lower rates of increase are mitigating effects of elk on park vegetation, other wildlife, and neighboring lands and will facilitate population control, but may reduce opportunities for elk hunting outside the park. ?? 2011 The Wildlife Society.

  3. A cross-sectional, comparative study of pain and activity in persons with and without injection-related venous ulcers.

    PubMed

    Pieper, Barbara; DiNardo, Ellen; Nordstrom, Cheryl K

    2013-05-01

    Persons with leg ulcers, including venous ulcers, often report pain. A cross-sectional, comparative study was conducted among 61 patients receiving care in an urban clinic (31 with and 30 without a venous ulcer, mean age 54 years [range 40 to 65 years], 93% African American) to examine pain and its relation to activity and walking in persons with injectionrelated venous ulcers. The questionnaire included items about pain and its treatment, as well as activity and walking (ie, Brief Pain Inventory [BPI] Short Form, Self-Treatment of Pain, Pain and Narcotic Use, Difficulty with Activities, and Walking Scale questionnaires). Among those with a venous ulcer (VU+), worst pain significantly related to total interference (r = 0.65, P <0.0001) and total difficulty (r = 0.42, P = 0.02) BPI scores. The common pain sites for those VU+ involved the legs (24, 36.4%), wound sites (13, 19.7%), back (eight, 12.1%), general body (five, 7.6%), shoulder and knee (four, 6.1% each), and other (eight, 12.1%). Persons VU+ were more likely than those without a venous ulcer (VU-) to have received a prescription for narcotics in the past year (96% versus 41%, X(2) = 21.3, P <0.0001). Persons VU+ versus VU- were significantly (X(2) = 8.89, P = 0.003) more likely to resort to street drug use and relapse to addiction if pain was not adequately treated. They were also twice as likely to have decreased walking over the past 5 years (67% versus 33%, X(2) = 5.93, P <0.02). Among those VU+, venous ulcers added to chronic pain and decreased walking. These findings highlight the negative effects of injection-related venous ulcers on pain, activity, and walking, as well as the propensity of this groupto resort to illicit drug use for pain control. Persons VU+ should have pain assessed and treated. PMID:23669257

  4. Reduced-Order Models for Load Management in the Power Grid

    NASA Astrophysics Data System (ADS)

    Alizadeh, Mahnoosh

    In recent years, considerable research efforts have been directed towards designing control schemes that can leverage the inherent flexibility of electricity demand that is not tapped into in today's electricity markets. It is expected that these control schemes will be carried out by for-profit entities referred to as aggregators that operate at the edge of the power grid network. While the aggregator control problem is receiving much attention, more high-level questions of how these aggregators should plan their market participation, interact with the main grid and with each other, remain rather understudied. Answering these questions requires a large-scale model for the aggregate flexibility that can be harnessed from the a population of customers, particularly for residences and small businesses. The contribution of this thesis towards this goal is divided into three parts: In Chapter 3, a reduced-order model for a large population of heterogeneous appliances is provided by clustering load profiles that share similar degrees of freedom together. The use of such reduced-order model for system planning and optimal market decision making requires a foresighted approximation of the number of appliances that will join each cluster. Thus, Chapter 4 provides a systematic framework to generate such forecasts for the case of Electric Vehicles, based on real-world battery charging data. While these two chapters set aside the economic side that is naturally involved with participation in demand response programs and mainly focus on the control problem, Chapter 5 is dedicated to the study of optimal pricing mechanisms in order to recruit heterogeneous customers in a demand response program in which an aggregator can directly manage their appliances' load under their specified preferences. Prices are proportional to the wholesale market savings that can result from each recruitment event.

  5. Reduced fine sediment flux in response to the managed diversion of an upland river channel

    NASA Astrophysics Data System (ADS)

    Perks, M. T.; Warburton, J.

    2015-10-01

    This paper describes the implementation of a novel mitigation approach and subsequent adaptive management, designed to reduce the transfer of fine sediment in Glaisdale Beck; a small upland catchment in the UK. Hydro-meteorological and suspended sediment datasets are collected over a two year period spanning pre- and post-diversion periods in order to assess the impact of the channel reconfiguration scheme on the fluvial suspended sediment dynamics. Analysis of the river response demonstrates that the fluvial sediment system has become more restrictive with reduced fine sediment transfer. This is characterised by reductions in flow-weighted mean suspended sediment concentrations from 77.93 mg L-1 prior to mitigation, to 74.36 mg L-1 following the diversion. A Mann-Whitney U test found statistically significant differences (p < 0.001) between the pre- and post-monitoring median SSCs. Whilst application of one-way analysis of covariance (ANCOVA) on the coefficients of sediment rating curves developed before and after the diversion found statistically significant differences (p < 0.001), with both Log a and b coefficients becoming smaller following the diversion. Non-parametric analysis indicates a reduction in residuals through time (p < 0.001), with the developed LOWESS model over-predicting sediment concentrations as the channel stabilises. However, the channel is continuing to adjust to the reconfigured morphology, with evidence of a headward propagating knickpoint which has migrated 120 m at an exponentially decreasing rate over the last 7 years since diversion. The study demonstrates that channel reconfiguration can be effective in mitigating fine sediment flux in upland streams but the full value of this may take many years to achieve whilst the fluvial system, slowly readjusts.

  6. Health management with reduced antibiotic use - the U.S. experience.

    PubMed

    Baker, Rodney

    2006-01-01

    Since World War II the use of antimicrobial products associated with food animal production has increased. Antimicrobials along with evolving production practices have significantly increased throughput, animal welfare, and improved health. Concerns surrounding the growing significance of emerging and in some cases rapidly disseminating antibiotic (antimicrobial) resistant bacterial pathogens among human and livestock populations has stimulated a reassessment of this application. The negative publicity has led many consumers and activist groups to believe that protein derived from food animals grown in the absence of those drugs is safer than products derived from the conventionally reared. There is a general fear that antimicrobial usage in agriculture threatens the sustainability of human therapeutic agents and the public wellbeing. The issue has gradually emerged from "fringe group paranoia" to mainstream - finally impacting consumer choices. Antimicrobial resistance concerns have stimulated a significant reaction by the US animal agriculture industry. Numerous pig production entities, large and small, have attempted to create additional pork product value by developing niche marketing opportunities. Thus far most of the subtherapeutic in-feed antimicrobial reduction has been voluntary in the US. Two production areas have developed where reduced usage occurs. First is the growth of antibiotic free production (ABF) and second is an increased use of treatment levels which avoids subtherapeutic criticism. The bulk of this article is directed at new production practices, pig health management, disease elimination, and biosecurity efforts that result from early industry attempts at reduced or excluded antimicrobial pig production. Raising antimicrobial (antibiotic) free (ABF) pork from birth is challenging for a variety of reasons. Some of these challenges can be cost effectively dealt with while others are difficult if not impossible to control in modern production

  7. Integrated nutrient management (INM) for sustaining crop productivity and reducing environmental impact: a review.

    PubMed

    Wu, Wei; Ma, Baoluo

    2015-04-15

    The increasing food demands of a growing human population and the need for an environmentally friendly strategy for sustainable agricultural development require significant attention when addressing the issue of enhancing crop productivity. Here we discuss the role of integrated nutrient management (INM) in resolving these concerns, which has been proposed as a promising strategy for addressing such challenges. INM has multifaceted potential for the improvement of plant performance and resource efficiency while also enabling the protection of the environment and resource quality. This review examines the concepts, objectives, procedures and principles of INM. A comprehensive literature search revealed that INM enhances crop yields by 8-150% compared with conventional practices, increases water-use efficiency, and the economic returns to farmers, while improving grain quality and soil health and sustainability. Model simulation and fate assessment further reveal that reactive nitrogen (N) losses and GHG (greenhouse gas) emissions are reduced substantially under advanced INM practices. Lower inputs of chemical fertilizer and therefore lower human and environmental costs (such as intensity of land use, N use, reactive N losses and GHG emissions) were achieved under advanced INM practices without compromising crop yields. Various approaches and perspectives for further development of INM in the near future are also proposed and discussed. Strong and convincing evidence indicates that INM practice could be an innovative and environmentally friendly strategy for sustainable agriculture worldwide. PMID:25644838

  8. Possible land management uses of common cypress to reduce wildfire initiation risk: a laboratory study.

    PubMed

    Della Rocca, G; Hernando, C; Madrigal, J; Danti, R; Moya, J; Guijarro, M; Pecchioli, A; Moya, B

    2015-08-15

    Accurate determination of flammability is required in order to improve knowledge about vegetation fire risk. Study of the flammability of different plant species is essential for the Mediterranean area, where most ecosystems are adapted to natural fire but vulnerable to recurrent human-induced fires, which are the main cause of forest degradation. However, the methods used to evaluate vegetation flammability have not yet been standardized. Cupressus sempervirens is a native or naturalized forest tree species in the Mediterranean area that is able to tolerate prolonged drought and high temperatures. The aim of this study was to characterize the flammability of C. sempervirens var. horizontalis at particle level by using different bench-scale calorimetry techniques (mass loss calorimeter, epiradiator and oxygen bomb) to determine the main flammability descriptors (ignitability, sustainability, combustibility and consumability) in live crown and litter samples. Our findings indicate that this variety of cypress is relatively resistant to ignition because of the high ash content, the high critical heat flux, the high time to ignition displayed by both crown and litter samples and the ability of the leaves to maintain a high water content during the summer. We also discuss the possibility of exploiting some morphological, functional and ecological traits of the species to construct a barrier system (with selected varieties of cypress) as a promising complementary land management tool to reduce the fire spread and intensity in a Mediterranean context. PMID:26046989

  9. Longitudinal annoyance responses to a road traffic noise management strategy that reduced heavy vehicles at night.

    PubMed

    Brown, A L

    2015-01-01

    A traffic management strategy was designed to reduce trucks using an urban corridor. The intervention had potential to affect night-time truck flows, but did not target truck traffic in the day, or vehicles other than trucks at any hour. A two-year long panel study measured the community's response to this intervention, using five repeated measurements of response. There were significant reductions in the panel's response to noise, both for night-time annoyance and for interference with activities. This was remarkable given that noise monitoring showed that the intervention produced no change in conventional traffic noise indicators. However, there were measureable changes in the number of articulated truck movements at night, and the benefit can be attributed to reduction in the number of noise events from heavy vehicles. The parallel tracking of changes in reported noise effects and the numbers of heavy vehicles in the night hours in this longitudinal study provides strong support to the notion that noise effects at night depend on the number of noise events experienced, not only on the overall level of traffic noise. The latter appear to be unresponsive indicators by which to assess the noise-effect benefit of heavy vehicle reduction strategies. PMID:25618048

  10. Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

    PubMed Central

    Menezes, Esme V; Yakoob, Mohammad Yawar; Soomro, Tanya; Haws, Rachel A; Darmstadt, Gary L; Bhutta, Zulfiqar A

    2009-01-01

    Background An estimated two-thirds of the world's 3.2 million stillbirths occur antenatally, prior to labour, and are often overlooked in policy and programs. Poorly recognised, untreated or inadequately treated maternal infections such as syphilis and malaria, and maternal conditions including hypertensive disorders, are known risk factors for stillbirth. Methods We undertook a systematic review of the evidence for 16 antenatal interventions with the potential to prevent stillbirths. We searched a range of sources including PubMed and the Cochrane Library. For interventions with prior Cochrane reviews, we conducted additional meta-analyses including eligible newer randomised controlled trials following the Cochrane protocol. We focused on interventions deliverable at the community level in low-/middle-income countries, where the burden of stillbirths is greatest. Results Few of the studies we included reported stillbirth as an outcome; most that did were underpowered to assess this outcome. While Cochrane reviews or meta-analyses were available for many interventions, few focused on stillbirth or perinatal mortality as outcomes, and evidence was frequently conflicting. Several interventions showed clear evidence of impact on stillbirths, including heparin therapy for certain maternal indications; syphilis screening and treatment; and insecticide-treated bed nets for prevention of malaria. Other interventions, such as management of obstetric intrahepatic cholestasis, maternal anti-helminthic treatment, and intermittent preventive treatment of malaria, showed promising impact on stillbirth rates but require confirmatory studies. Several interventions reduced known risk factors for stillbirth (e.g., anti-hypertensive drugs for chronic hypertension), yet failed to show statistically significant impact on stillbirth or perinatal mortality rates. Periodontal disease emerged as a clear risk factor for stillbirth but no interventions have reduced stillbirth rates

  11. Reducing diabetes disparities through the implementation of a community health worker-led diabetes self-management education program.

    PubMed

    Walton, James W; Snead, Christine A; Collinsworth, Ashley W; Schmidt, Kathryn L

    2012-01-01

    Disparities in prevalence of type 2 diabetes and complications in underserved populations have been linked to poor quality of care including lack of access to diabetes management programs. Interventions utilizing community health workers (CHWs) to assist with diabetes management have demonstrated improvements in patient outcomes. Use of CHWs may be an effective model for providing care coordination and reducing disparities, but there is limited knowledge on how to implement this model on a large scale. This article describes how an integrated health care system implemented a CHW-led diabetes self-management education program targeting Hispanic patients and reports lessons learned from the first 18 months of operation. PMID:22367263

  12. Reduced Population Control of an Insect Pest in Managed Willow Monocultures

    PubMed Central

    Dalin, Peter; Kindvall, Oskar; Björkman, Christer

    2009-01-01

    Background There is a general belief that insect outbreak risk is higher in plant monocultures than in natural and more diverse habitats, although empirical studies investigating this relationship are lacking. In this study, using density data collected over seven years at 40 study sites, we compare the temporal population variability of the leaf beetle Phratora vulgatissima between willow plantations and natural willow habitats. Methodology/Principal Findings The study was conducted in 1999–2005. The density of adult P. vulgatissima was estimated in the spring every year by a knock-down sampling technique. We used two measures of population variability, CV and PV, to compare temporal variations in leaf beetle density between plantation and natural habitat. Relationships between density and variability were also analyzed to discern potential underlying processes behind stability in the two systems. The results showed that the leaf beetle P. vulgatissima had a greater temporal population variability and outbreak risk in willow plantations than in natural willow habitats. We hypothesize that the greater population stability observed in the natural habitat was due to two separate processes operating at different levels of beetle density. First, stable low population equilibrium can be achieved by the relatively high density of generalist predators observed in natural stands. Second, stable equilibrium can also be imposed at higher beetle density due to competition, which occurs through depletion of resources (plant foliage) in the natural habitat. In willow plantations, competition is reduced mainly because plants grow close enough for beetle larvae to move to another plant when foliage is consumed. Conclusion/Significance To our knowledge, this is the first empirical study confirming that insect pest outbreak risk is higher in monocultures. The study suggests that comparative studies of insect population dynamics in different habitats may improve our ability to

  13. Synergi and E&P forum HSE management system helps companies improve HSE performance and reduce losses

    SciTech Connect

    Grundt, H.J.

    1996-12-31

    This paper discusses the use of information on accidents and near-misses to improve HSE performance and reduce losses in Exploration and Production activities. Incidents are considered a result of management system failure. To avoid incidents and recurrence of incidents, companies should adopt an integrated HSE Management System and software especially designed for recording, analyzing and following up events. The E&P Forum has issued guidelines to support current company HSE Management systems and practices. Concurrently, the Synergi Project has been established to facilitate experience transfer and effective handling of incidents as part of an integrated HSE Management System. The paper describes how important it is to learn from past mistakes, to have a management system which facilitates the implementation of the required corrective action, and that tools for improved loss control are available.

  14. Integrating land cover modeling and adaptive management to conserve endangered species and reduce catastrophic fire risk

    USGS Publications Warehouse

    Breininger, David; Duncan, Brean; Eaton, Mitchell J.; Johnson, Fred; Nichols, James

    2014-01-01

    Land cover modeling is used to inform land management, but most often via a two-step process, where science informs how management alternatives can influence resources, and then, decision makers can use this information to make decisions. A more efficient process is to directly integrate science and decision-making, where science allows us to learn in order to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by the specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuel monitoring with decision-making focused on the dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy; other conditions require tradeoffs between objectives. Knowledge about system responses to actions can be informed by developing hypotheses based on ideas about fire behavior and then applying competing management actions to different land units in the same system state. Monitoring and management integration is important to optimize state-specific management decisions and to increase knowledge about system responses. We believe this approach has broad utility and identifies a clear role for land cover modeling programs intended to inform decision-making.

  15. The Slope of Change: An Environmental Management Approach to Reduce Drinking on a Day of Celebration at a US College

    ERIC Educational Resources Information Center

    Marchell, Timothy C.; Lewis, Deborah D.; Croom, Katherine; Lesser, Martin L.; Murphy, Susan H.; Reyna, Valerie F.; Frank, Jeremy; Staiano-Coico, Lisa

    2013-01-01

    Objective: This research extends the literature on event-specific environmental management with a case study evaluation of an intervention designed to reduce student drinking at a university's year-end celebration. Participants: Cornell University undergraduates were surveyed each May from 2001 through 2009. Sample sizes ranged from 322 to…

  16. Design of Experiments with Multiple Independent Variables: A Resource Management Perspective on Complete and Reduced Factorial Designs

    ERIC Educational Resources Information Center

    Collins, Linda M.; Dziak, John J.; Li, Runze

    2009-01-01

    An investigator who plans to conduct an experiment with multiple independent variables must decide whether to use a complete or reduced factorial design. This article advocates a resource management perspective on making this decision, in which the investigator seeks a strategic balance between service to scientific objectives and economy.…

  17. Reducing environmental noise impacts: A USAREUR noise-management program handbook. Final report

    SciTech Connect

    Feather, T.D.; Shekell, T.K.

    1991-06-01

    Noise pollution is a major environmental problem faced by the U.S. Army in Europe. Noise-related complaints from German citizens can escalate into intense political issues in German communities. This in turn hampers efficient operation of military training and often times threatens the Army's mission. In order to remedy these problems, USAREUR has developed a noise management program. A successful noise management program will limit the impact of unavoidable noise on the populace. This report, a component of the noise management program, is a reference document for noise management planning. It contains guidelines and rules-of-thumb for noise management. This document contains procedures which operation and training level personnel can understand and apply in their day to day noise management planning. Noise mitigation tips are given. Basic technical information that will aid in understanding noise mitigation is provided along with noise management through land use planning. Noise management for specific components of the military community, (airfields, base operations, training areas, and housing and recreation areas) are addressed. The nature of noise generated, means of noise abatement at the source, path, and receiver (both physical and organizational/public relations methods), and a case study example are described.

  18. Environmental Management: A Comprehensive Strategy for Reducing Alcohol and Other Drug Use on College Campuses.

    ERIC Educational Resources Information Center

    DeJong, William; Vince-Whitman, Cheryl; Colthurst, Tom; Cretella, Maggie; Gilbreath, Michael; Rosati, Michael; Zweig, Karen

    This guide presents a comprehensive strategy, called "environmental management," for alcohol and other drug (AOD) prevention in institutions of higher education. The environmental management approach utilizes, in addition to educational programs, changes in the physical, social, economic, and legal environment accomplished through a combination of…

  19. Use of Turf Management Practices to Reduce Nutrient and Pesticide Loads with Runoff from Fairway Turf

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The use of fertilizers and pesticides in highly managed turf systems has raised questions concerning their off-site transport to surrounding areas. To address these questions we designed experiments to measure the quantity of fertilizers and pesticides transported with runoff from turf plots managed...

  20. Reducing CH4 emission from rice paddy fields by altering water management

    NASA Astrophysics Data System (ADS)

    Sudo, S.; Itoh, M.

    2010-12-01

    Percentage of atmospheric methane emitted form rice paddy is estimated at 60Tg/yr (20 - 100Tg/yr) which is near 10% of total global methane emission of 535Tg/yr (410 - 660Tg) (IPCC(1995), and which is near 30% of anthropogenic CH4 emission. Thus, mitigation of CH4 emission is urgently required. CH4 in paddy soil is emanated by the activities of anaerobic bacteria which is called methane producer through reduction of CO2 or decomposition of acetic acid, and it is transported to atmosphere through soil or paddy water surface. It is effective to control methane emission from rice paddy that period is extended on intermittent drainage, composted rice straw is incorporated as fertilizer instead of flesh one, or other. However, empirical approach of these kinds of experiments had not been sufficient because such a kind of experiment required significant times and efforts. In this study, we conducted demonstrative experiments to verify the effects of water management method differences in order to reduce CH4 emission from rice paddy at 9 experimental sites in 8 prefectures. In this, we used new gas analyzer which can measure CH4, CO2 and N2O at once developed by National Institute for Agro-Environmental Sciences (NIAES), Japan. In this report, we show the results in two years of this study. 'Nakaboshi' (mid-season-drainage) is one of cultivation methods in rice paddy that surface water in paddy field is once drained for about 10 days and the field is maintained like upland field to give adequate stress to rice plant for better harvest qualities and yields. Our targeted evaluation was dependencies of Nakaboshi periods lengths and Nakaboshi periods to CH4 emission reduction amounts for total cultivation periods within harvest yield maintained. The longer length of Nakaboshi period was extended, the lesser CH4 emitted even after when Nakaboshi period lasted, as a whole. In some cases, for example in Kagoshima, exceptional phenomena of that significant high emission were

  1. Medication Management in Schools: A Systems Approach to Reducing Risk and Strengthening Quality in School Medication Management

    ERIC Educational Resources Information Center

    Center for Health and Health Care in Schools, 2004

    2004-01-01

    This paper and the invitational meeting for which it has been prepared make certain assumptions about the challenge of strengthening the quality of medication management in school. The participants believe that recent research on improving the safety and quality of patient care has relevance for health services in school, particularly the safety…

  2. Regional growth management policies: Toward reducing global warming at state and local levels

    SciTech Connect

    Purdie, J.

    1995-09-01

    State and local governments in the United States are accepting mandates to coordinate legislated land use and growth management planning with vigorous environmental protection and resource conservation. These mandates, implemented or planned in states with populations totaling over 100 million, will directly impact growth patterns and ultimately affect the level of atmospheric gases and particulates generated within their borders. This paper addresses the issues of growth management and land use planning at the local, state and regional levels and identifies areas impacting global warming. A review of existing systems will be presented, and recommendations will be made to improve monitoring of growth management mechanisms and organizational structures with the goal of global atmospheric improvement. The issues discussed include urban sprawl, transportation, and growth patterns as managed by policies also designed to protect environments and provide for sustainable growth. Areas for improved coordination between jurisdictions to ease global warming will also be examined.

  3. Reducing energy costs at state agencies and institutions in Texas through the Governor's energy management center

    SciTech Connect

    White, J.A.

    1989-01-01

    The one year internship required for partial fulfillment of the Doctor of Engineering Degree was completed at the Governor's Energy Management Center in Austin, Texas. The intern worked for the State Agencies Department of the Energy Management Center. The intern was involved in a variety of projects, but the primary projects requiring the greatest time were the involvement with the design reviews for energy efficiency of new prisons being constructed in Texas, conducting energy management audits at 18 major state universities, and the technical and administrative assistance to the State Cogeneration Council. Other project involvement included managing the preliminary engineering design of the cogeneration facility at Austin State Hospital, responsibility for applying for a $1.4 million dollar crude oil refund on the behalf of all state agencies in Texas, and assisting in the planning and coordination of the $48 million Revolving Loan Program for the state of Texas. The internship taught many things about management and communications. The experience also provided a better understanding of how the state and federal government operate. The greatest contribution of the internship experience was the improvement of the intern's written and oral communication skills.

  4. Reducing the distance: providing challenging and engaging online postgraduate education in pain management

    PubMed Central

    Henderson, Sarah E

    2012-01-01

    Summary points 1. Health professionals need access to flexible, high-quality, advanced education in pain management. 2. There are multiple pedagogical distances to be negotiated in the delivery of effective postgraduate education. 3. A critical consideration in the design and delivery of effective online learning for postgraduate education in pain management is how to: actively engage students in the learning process; and encourage students to become lifelong learners. 4. Conceptual frameworks for encouraging student interaction online provide a useful tool in the design of postgraduate online learning activities. PMID:26516472

  5. Reducing the risks of herbicide resistance: best management practices and recommendations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Herbicides are the foundation of weed control in commercial crop production. However, herbicide-resistant weed populations are developing rapidly in response to selection pressure. Critical practices include reducing selection through diversification of weed control techniques, minimizing spread of ...

  6. Farm-economic analysis of reducing antimicrobial use whilst adopting improved management strategies on farrow-to-finish pig farms.

    PubMed

    Rojo-Gimeno, Cristina; Postma, Merel; Dewulf, Jeroen; Hogeveen, Henk; Lauwers, Ludwig; Wauters, Erwin

    2016-07-01

    Due to increasing public health concerns that food animals could be reservoirs for antibiotic resistant organisms, calls for reduced current antibiotic use on farms are growing. Nevertheless, it is challenging for farmers to perform this reduction without negatively affecting technical and economic performance. As an alternative, improved management practices based on biosecurity and vaccinations have been proven useful to reduce antimicrobial use without lowering productivity, but issues with insufficient experimental design possibilities have hindered economic analysis. In the present study a quasi-experimental approach was used for assessing the economic impact of reduction of antimicrobial use coupled with improved management strategies, particularly biosecurity strategies. The research was performed on farrow-to-finish pig farms in Flanders (northern region of Belgium). First, to account for technological progress and to avoid selection bias, propensity score analysis was used to compare data on technical parameters. The treatment group (n=48) participated in an intervention study whose aim was to improve management practices to reduce the need for use of antimicrobials. Before and after the change in management, data were collected on the technical parameters, biosecurity status, antimicrobial use, and vaccinations. Treated farms were matched without replacement with control farms (n=69), obtained from the Farm Accountancy Data Network, to estimate the difference in differences (DID) of the technical parameters. Second, the technical parameters' DID, together with the estimated costs of the management intervention and the price volatility of the feed, meat of the finisher pigs, and piglets served as a basis for modelling the profit of 11 virtual farrow-to-finish pig farms representative of the Flemish sector. Costs incurred by new biosecurity measures (median +€3.96/sow/year), and new vaccinations (median €0.00/sow/year) did not exceed the cost reduction

  7. Strategic Management of ELT in Public Educational Systems: Trying to Reduce Failure, Increase Success

    ERIC Educational Resources Information Center

    Davies, Paul

    2009-01-01

    English as a foreign/second language teaching (ELT) is notably successful in some national public educational systems and unsuccessful in others. Holland, Singapore and Sweden are outstanding examples of great success in the strategic management of ELT in their public educational systems. General failures abound, particularly in countries that…

  8. Risk Management: How School Districts Can Identify Risks, Reduce Losses, and Conserve Funds.

    ERIC Educational Resources Information Center

    Gaustad, Joan

    1993-01-01

    The ordinary conduct of school business is accompanied today by risks that were rare or unknown a few decades ago. School administrators are continually being challenged to develop new strategies to safeguard their districts' assets. Risk management is a coordinated effort to protect an organization's assets, both human and financial, from all…

  9. Working to Reduce the Effects of Discrimination: Identity Management Strategies in Organizations

    ERIC Educational Resources Information Center

    Shih, Margaret; Young, Maia J.; Bucher, Amy

    2013-01-01

    Despite efforts to dispel discrimination, workplace discrimination still occurs. We introduce two classes of identity management strategies individuals use to mitigate the negative consequences of discrimination: identity switching (i.e., deemphasizing target identities and recategorizing to a more positively valued identity) and identity…

  10. Debriefing Can Reduce Misperceptions of Feedback: The Case of Renewable Resource Management

    ERIC Educational Resources Information Center

    Qudrat-Ullah, Hassan

    2007-01-01

    According to the hypothesis of misperception of feedback, people's poor performance in renewable resource management tasks can be attributed to their general tendency to systematically misperceive the dynamics of bioeconomic systems. The thesis of this article is that dynamic decision performance can be improved by helping individuals develop more…

  11. Understanding and Reducing the Impact of Defensiveness on Management Learning: Some Lessons from Neuroscience

    ERIC Educational Resources Information Center

    Holmer, Leanna L.

    2014-01-01

    The neurosciences have expanded our understanding of the role of the "old" brain in generating defensive reactions to threat. Because the learning and practice of management skills pose various forms of threat to would-be practitioners, the question of how individuals respond to threat and how this affects their ability to learn has also…

  12. Prefire (preemptive) management to decrease fire-induced bunchgrass mortality and reduce reliance on postfire seeding

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Western rangelands are currently under severe threat from exotic annual grasses. To successfully manage rangelands that are either infested with or susceptible to exotic annual grasses, we must focus on increasing resilience to disturbance and resistance to exotic annual grass invasion. Here, we p...

  13. The Effects of Contingency Management as a Means of Reducing Truancy.

    ERIC Educational Resources Information Center

    Spencer-Dunbar, Louise Hall

    Based on the assumption that truancy is a discrete form of behavior alterable by manipulation, rather than just a symptom of some underlying problem, an experiment among ninth graders investigated the effect of contingency management (using rewards to effect behavior changes) on truancy. Identification of habitual truants to participate in the…

  14. Management practices to reduce lupine-induced Crooked Calf Syndrome in the Northwest

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many factors contribute to the incidence of lupine-induced “Crooked Calf Syndrome” (CCS) in the northwestern U.S. A 1-5% incidence of CCS is common on many ranches and higher incidences occur when environmental conditions are conducive to lupine population increases. Multiple management strategies s...

  15. Lack of cross-scale linkages reduces robustness of community-based fisheries management.

    PubMed

    Cudney-Bueno, Richard; Basurto, Xavier

    2009-01-01

    Community-based management and the establishment of marine reserves have been advocated worldwide as means to overcome overexploitation of fisheries. Yet, researchers and managers are divided regarding the effectiveness of these measures. The "tragedy of the commons" model is often accepted as a universal paradigm, which assumes that unless managed by the State or privatized, common-pool resources are inevitably overexploited due to conflicts between the self-interest of individuals and the goals of a group as a whole. Under this paradigm, the emergence and maintenance of effective community-based efforts that include cooperative risky decisions as the establishment of marine reserves could not occur. In this paper, we question these assumptions and show that outcomes of commons dilemmas can be complex and scale-dependent. We studied the evolution and effectiveness of a community-based management effort to establish, monitor, and enforce a marine reserve network in the Gulf of California, Mexico. Our findings build on social and ecological research before (1997-2001), during (2002) and after (2003-2004) the establishment of marine reserves, which included participant observation in >100 fishing trips and meetings, interviews, as well as fishery dependent and independent monitoring. We found that locally crafted and enforced harvesting rules led to a rapid increase in resource abundance. Nevertheless, news about this increase spread quickly at a regional scale, resulting in poaching from outsiders and a subsequent rapid cascading effect on fishing resources and locally-designed rule compliance. We show that cooperation for management of common-pool fisheries, in which marine reserves form a core component of the system, can emerge, evolve rapidly, and be effective at a local scale even in recently organized fisheries. Stakeholder participation in monitoring, where there is a rapid feedback of the systems response, can play a key role in reinforcing cooperation

  16. Sodium chlorate reduces presence of Escherichia coli in feces of lambs and ewes managed in shed-lambing systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our objective was to establish doses of orally-administered NaClO3 that reduced presence of generic Escherichia coli in intestines of ewes and neonatal lambs managed in a shed-lambing system. Neonatal lambs (n = 32; age = 7.1 ± 1.2 d; BW = 6.8 ± 1.0 kg) and yearling ewes (n = 44; BW = 74.8 ± 5.6 kg)...

  17. Damage Characterization Method for Structural Health Management Using Reduced Number of Sensor Inputs

    NASA Technical Reports Server (NTRS)

    Krishnamurthy, T.; Hochhalter, Jacob D.; Gallegos, Adam M.

    2012-01-01

    The development of validated multidisciplinary Integrated Vehicle Health Management (IVHM) tools, technologies, and techniques to enable detection, diagnosis, prognosis, and mitigation in the presence of adverse conditions during flight will provide effective solutions to deal with safety related challenges facing next generation aircraft. The adverse conditions include loss of control caused by environmental factors, actuator and sensor faults or failures, and damage conditions. A major concern in these structures is the growth of undetected damage (cracks) due to fatigue and low velocity foreign impacts that can reach a critical size during flight, resulting in loss of control of the aircraft. Hence, development of efficient methodologies to determine the presence, location, and severity of damage in critical structural components is highly important in developing efficient structural health management systems.

  18. Telehealth interventions to reduce management complications in type 1 diabetes: A review

    PubMed Central

    Balkhi, Amanda M; Reid, Adam M; Westen, Sarah C; Olsen, Brian; Janicke, David M; Geffken, Gary R

    2015-01-01

    Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided. PMID:25897348

  19. Managing Medical Costs by Reducing Demand for Services: The Missing Element in Health Care Reform.

    ERIC Educational Resources Information Center

    Kelly, Edward K.; And Others

    1994-01-01

    It is argued that higher education institutions can play a major role in health care reform by providing campus cultures that foster healthy lifestyle choices and in turn reduce medical costs. Specific issues discussed include elimination of unnecessary tests, focus on special high-risk populations, and use of advance directives. (MSE)

  20. Improvements in Care and Reduced Self-Management Barriers Among Rural Patients With Diabetes

    ERIC Educational Resources Information Center

    Dettori, Nancy; Flook, Benjamin N.; Pessl, Erich; Quesenberry, Kim; Loh, Johnson; Harris, Colleen; McDowall, Janet M.; Butcher, Marcene K.; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

    2005-01-01

    Improved preventive care and clinical outcomes among patients with diabetes can reduce complications and costs; however, diabetes care continues to be suboptimal. Few studies have described effective strategies for improving care among rural populations with diabetes. In 2000, the Park County Diabetes Project and the Montana Diabetes Control…

  1. Corn and soybean rotation under reduced tillage management: impacts on soil properties, yield, and net return

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A 4-yr field study was conducted from 2007 to 2010 at Stoneville, MS to examine the effects of rotating corn and soybean under reduced tillage conditions on soil properties, yields, and net return. The six rotation systems were continuous corn (CCCC), continuous soybean (SSSS), corn-soybean (CSCS),...

  2. Best Nitrogen Management Practices Can Reduce the Potential Flux of Nitrogen Out of the Arkansas Delta

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It has been reported that nitrogen losses in the Arkansas Delta can contribute to the flux of nitrogen into the Mississippi River Basin, which can in turn contribute to the nitrate load that the hypoxia problem in the Gulf of Mexico has been attributed to. Developing effective methods of reducing th...

  3. Cover crop use for weed management in Southern reduced-tillage vegetable cropping systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    With growing agricultural demands from both conventional and organic systems comes the need for sustainable practices to ensure long-term productivity. Implementation of reduced- or no-till practices offers a number of environmental benefits for agricultural land and maintains adequate yield for cu...

  4. Collaborative Care Management Reduces Disparities in Dementia Care Quality for Caregivers with Less Education

    PubMed Central

    Brown, Arleen F.; Vassar, Stefanie D.; Connor, Karen I.; Vickrey, Barbara G.

    2013-01-01

    BACKGROUND Lower educational attainment among informal caregivers’ may be associated with poorer outcomes for patients with dementia. OBJECTIVE To examine educational gradients in dementia care and whether the effect of a dementia collaborative care management intervention varied by the educational attainment of the informal caregiver. DESIGN Analysis of data from a cluster-randomized controlled trial. SETTING Eighteen clinics across 3 healthcare organizations in Southern California. PARTICIPANTS Dyads of Medicare recipients, ages 65 years and older with a diagnosis of dementia, and an eligible caregiver. INTERVENTION Collaborative care management for dementia. MEASUREMENTS 1) Caregiver educational attainment, 2) adherence to four dimensions of guideline-recommended processes of dementia care: Assessment, Treatment, Education/Support, and Safety pre- and post-intervention, and 3) the adjusted intervention effect (IE) for each dimension stratified by caregiver education. Each IE was estimated by subtracting the difference between pre- and post-intervention scores for the usual care participants from the difference in the intervention participants. RESULTS At baseline, caregivers with lower educational attainment had lower guideline-recommended processes of dementia care for the Treatment and Education dimensions than those with more education. However, less educated caregivers had significantly more improvement after the intervention on the Assessment, Treatment, and Safety dimensions. The IEs for those who had not graduated from high school compared to college graduates were 44.4 vs. 29.5 for the Assessment dimension (P<0.001), 36.9 vs. 15.7 for the Treatment dimension (P<0.001), and 52.7 vs. 40.9 for the Safety Dimension (P<0.001). CONCLUSIONS Collaborative care management was associated with reductions in disparities in dementia care quality among caregivers with lower educational attainment relative to more educated caregivers. PMID:23320655

  5. A management strategy to reduce bacterial pollution in shellfish areas: A case study

    NASA Astrophysics Data System (ADS)

    Crane, Stuart R.; Moore, James A.

    1986-01-01

    The problem of bacterial pollution in shellfishing areas is not uncommon in the coastal regions of the United States. Bacterial contamination from man's activities can effectively reduce our natural shellfish resource areas by forcing their closure because of high potential risk of diseases being spread by shellfish harvested in these areas. Tillamook Bay, a relatively small, enclosed drainage basin of nonurban character, presents an excellent study area for observing this problem. The high population density of animals, raised on a relatively small floodplain area, represents one of the major sources of pollution in the bay. This paper summarizes the history of the agencies involved with the problem and presents the current approach to alleviate bacterial pollution in the bay without unduly penalizing other industries in the Tillamook basin. The paper also presents some of the legal aspects of reducing water pollution in shellfish harvesting areas and the jurisdiction of federal agencies in these matters. Finally, recommendations are given to reduce bacterial output by the major source categories in the basin, and criteria for bay closure to shellfish harvest are developed to protect the public from bacterially contaminated shellfish.

  6. Assessing management options to reduce water temperatures in regulated rivers of California

    NASA Astrophysics Data System (ADS)

    Pike, A.; Danner, E.; Boughton, D. A.; Harrison, L.

    2014-12-01

    In many regulated rivers throughout the western United States, deliberate management of water temperature below reservoirs is crucial to the survival of endangered salmonids. However, management options at reservoirs are often limited to adjusting either the flow volume and/or release temperature to alter the downstream water temperature. Here we investigate the efficacy of this approach in three major regulated rivers in California: the Sacramento River, the Klamath River, and the St. Ynez River. We use a 1-dimensional water temperature model (RAFT) to compute heat fluxes to/from the river based on meteorological conditions, channel bathymetry, and reservoir releases. A sensitivity analysis evaluates the thermal response of the river to reservoir releases during summertime flow conditions. Results indicate that the water temperature dynamics downstream of reservoirs vary between rivers. Although both the Sacramento and Klamath Rivers exhibit cooling in response to increased flows, the Sacramento River is cooled more effectively by decreasing the release temperature. In contrast, increased flow rate in the St. Ynez River does not as strongly influence downstream temperatures due to shallower flows combined with significant thermal buffering already provided by deep alluvial streambed.

  7. Reducing errors through a web-based self-management support system.

    PubMed

    Ekstedt, Mirjam; Børøsund, Elin; Svenningsen, Ina K; Ruland, Cornelia M

    2014-01-01

    Web-based self-management support systems SMSS, can successfully assist a wide range of patients with information and self-management support. O or as a stand-alone service, are e-messages. This study describes how one component of a multi component SMSS, an e-message service, in which patients with breast cancer could direct questions to nurses, physicians or social workers at the hospital where they were being treated, had an influence on safety and continuity of care. Ninety-one dialogues consisting of 284 messages were analysed. The communications between patients and the healthcare team revealed that the e-messages service served as a means for quality assurance of information, for double-checking and for coordination of care. We give examples of how an e-mail service may improve patients' knowledge in a process of taking control over their own care - increasingly important in a time of growing complexity and specialization in healthcare. It remains to be tested whether an e-message service can improve continuity of care and prevent or mitigate medical mishaps. PMID:24943563

  8. Organically managed soils reduce internal colonization of tomato plants by Salmonella enterica serovar Typhimurium.

    PubMed

    Gu, Ganyu; Cevallos-Cevallos, Juan M; Vallad, Gary E; van Bruggen, Ariena H C

    2013-04-01

    A two-phase experiment was conducted twice to investigate the effects of soil management on movement of Salmonella enterica Typhimurium in tomato plants. In the first phase, individual leaflets of 84 tomato plants grown in conventional or organic soils were dip inoculated two to four times before fruiting with either of two Salmonella Typhimurium strains (10(9) CFU/ml; 0.025% [vol/vol] Silwet L-77). Inoculated and adjacent leaflets were tested for Salmonella spp. densities for 30 days after each inoculation. Endophytic bacterial communities were characterized by polymerase chain reaction denaturing gradient gel electrophoresis before and after inoculation. Fruit and seed were examined for Salmonella spp. incidence. In phase 2, extracted seed were planted in conventional soil, and contamination of leaves and fruit of the second generation was checked. More Salmonella spp. survived in inoculated leaves on plants grown in conventional than in organic soil. The soil management effect on Salmonella spp. survival was confirmed for tomato plants grown in two additional pairs of soils. Endophytic bacterial diversities of tomato plants grown in conventional soils were significantly lower than those in organic soils. All contaminated fruit (1%) were from tomato plants grown in conventional soil. Approximately 5% of the seed from infested fruit were internally contaminated. No Salmonella sp. was detected in plants grown from contaminated seed. PMID:23506364

  9. Soil pH management without lime, a strategy to reduce greenhouse gas emissions from cultivated soils

    NASA Astrophysics Data System (ADS)

    Nadeem, Shahid; Bakken, Lars; Reent Köster, Jan; Tore Mørkved, Pål; Simon, Nina; Dörsch, Peter

    2015-04-01

    For decades, agricultural scientists have searched for methods to reduce the climate forcing of food production by increasing carbon sequestration in the soil and reducing the emissions of nitrous oxide (N2O). The outcome of this research is depressingly meagre and the two targets appear incompatible: efforts to increase carbon sequestration appear to enhance the emissions of N2O. Currently there is a need to find alternative management strategies which may effectively reduce both the CO2 and N2O footprints of food production. Soil pH is a master variable in soil productivity and plays an important role in controlling the chemical and biological activity in soil. Recent investigations of the physiology of denitrification have provided compelling evidence that the emission of N2O declines with increasing pH within the range 5-7. Thus, by managing the soil pH at a near neutral level appears to be a feasible way to reduce N2O emissions. Such pH management has been a target in conventional agriculture for a long time, since a near-neutral pH is optimal for a majority of cultivated plants. The traditional way to counteract acidification of agricultural soils is to apply lime, which inevitably leads to emission of CO2. An alternative way to increase the soil pH is the use of mafic rock powders, which have been shown to counteract soil acidification, albeit with a slower reaction than lime. Here we report a newly established field trail in Norway, in which we compare the effects of lime and different mafic mineral and rock powders (olivine, different types of plagioclase) on CO2 and N2O emissions under natural agricultural conditions. Soil pH is measured on a monthly basis from all treatment plots. Greenhouse gas (GHG) emission measurements are carried out on a weekly basis using static chambers and an autonomous robot using fast box technique. Field results from the first winter (fallow) show immediate effect of lime on soil pH, and slower effects of the mafic rocks. The

  10. Flood risk mitigation through natural flood management: reducing uncertainty through process studies at the local catchment scale

    NASA Astrophysics Data System (ADS)

    Wilkinson, M. E.; Quinn, P. F.; Nicholson, A.; O'Donnell, G. M.

    2012-04-01

    Intense farming has the potential to increase runoff rates. Therefore, there is great potential for managing land use to play a role in local scale strategies for managing flood risk. The European Floods Directive has created a platform for the management of flood risk. Natural flood management measures have a role in the implementation of the directive. One type of such natural flood management measures are Runoff Attenuation Features (RAFs). RAFs are cost effective soft engineered features used for slowing and storing water at the source during flood events. For the optimal use of such features, there is a need to ascertain how they operate across a range of flood events of varying return periods. Based on local scale knowledge and understanding, runoff flow pathways are identified, managed and runoff is tackled at the source. The Belford catchment, UK (5.7km2), is an example of a catchment whereby a range of RAF measures have been implemented to help reduce flood risk. Hydrological data from an extensive nested monitoring network have been collected over a four-year period. Over this period numerous RAFs were installed throughout the catchment and their effectiveness was tested against a large number of storm events. There are currently 30 RAFs in the catchment storing ~15,000m3. Qualitatively, evidence from the RAFs has showed that the features are functioning correctly during large events. They are slowing and storing runoff, and disconnecting fast flow pathways that are contributing to the flood hydrograph. There is also emerging evidence that suggests that the travel time of the peak is also being delayed. However, there is a large degree of uncertainty quantifying the degree in which the features are attenuating the flow, owing to natural variability in the short dataset. There is a need for data driven models based on field evidence to reduce the uncertainty. Quantitative analysis of the impact the RAFs have on reducing and delaying the peak discharge

  11. Reduce Driveline Trauma Through Stabilization and Exit Site Management: 30 Days Feasibility Results from the Multicenter RESIST Study.

    PubMed

    Stahovich, Marcia; Sundareswaran, Kartik S; Fox, Sarah; Hallinan, William; Blood, Peggy; Chen, Leway; Pamboukian, Salpy V; Chinn, Raymond; Farrar, David J; Pagani, Francis D; Blue, Laura

    2016-01-01

    The percutaneous lead management kit (PLMK) was developed for the HeartMate 2 (HM2) left ventricular assist device (LVAD) to reduce trauma at the exit site and to maintain a clean environment. REduce Driveline Trauma through StabIlization and Exit Site ManagemenT (RESIST) was a multicenter, prospective, nonrandomized study designed to evaluate the feasibility of the PLMK for managing the HM2 driveline exit site. Fifty patients were enrolled at five sites at a median of 495 days post-HM2 implant; 92% (46 of 50) of patients used the PLMK for a minimum of 30 days. At 30 days, more patients found the PLMK to be extremely comfortable (80% vs. 37%, p < 0.001) and extremely effective at stabilizing the driveline (82% vs. 40%, p < 0.001) compared with each center's standard of care. Frequency of dressing changes was 6-7 days or higher for 85% of the patients with PLMK. Three patients developed driveline infection while on PLMK (6%, 0.15 events per patient year), and 35 patients continued to use the PLMK after 6 months. The PLMK is easy to use, increases patient comfort, and increases driveline stability with a dressing change frequency of 6-7 days. PMID:27111738

  12. A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial

    PubMed Central

    Anderson, Jacqueline; Dolk, Anders; Torgerson, Jarl; Nyberg, Svante; Skau, Tommy; Forsberg, Birger C.; Werr, Joachim; Öhlen, Gunnar

    2016-01-01

    Background A small group of frequent visitors to Emergency Departments accounts for a disproportionally large fraction of healthcare consumption including unplanned hospitalizations and overall healthcare costs. In response, several case and disease management programs aimed at reducing healthcare consumption in this group have been tested; however, results vary widely. Objectives To investigate whether a telephone-based, nurse-led case management intervention can reduce healthcare consumption for frequent Emergency Department visitors in a large-scale setup. Methods A total of 12 181 frequent Emergency Department users in three counties in Sweden were randomized using Zelen’s design or a traditional randomized design to receive either a nurse-led case management intervention or no intervention, and were followed for healthcare consumption for up to 2 years. Results The traditional design showed an overall 12% (95% confidence interval 4–19%) decreased rate of hospitalization, which was mostly driven by effects in the last year. Similar results were achieved in the Zelen studies, with a significant reduction in hospitalization in the last year, but mixed results in the early development of the project. Conclusion Our study provides evidence that a carefully designed telephone-based intervention with accurate and systematic patient selection and appropriate staff training in a centralized setup can lead to significant decreases in healthcare consumption and costs. Further, our results also show that the effects are sensitive to the delivery model chosen. PMID:25969342

  13. Many-Objective Reservoir Policy Identification and Refinement to Reduce Institutional Myopia in Water Management

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Herman, J. D.; Castelletti, A.; Reed, P. M.

    2013-12-01

    Institutional inertia strongly limits our ability to adapt water reservoir operations to better manage growing water demands as well as their associated uncertainties in a changing climate. Although it has long been recognized that these systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, our broader understanding of the multiobjective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification and many-objective optimization under uncertainty to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. Initially our proposed framework uses available streamflow observations to implicitly identify the Conowingo Dam's current but unknown operating policy. This baseline policy is identified by fitting radial basis functions to existing system dynamics. Our assumption in the baseline policy is that the dam operator is represented as a rational agent seeking to maximize primary operational objectives (i.e., guaranteeing the public water supply and maximizing the hydropower revenue). The quality of the identified baseline policy is evaluated by its ability to replicate historical release dynamics. Once identified, the historical baseline policy then provides a means of representing

  14. Many-objective reservoir policy identification and refinement to reduce institutional myopia in water management

    NASA Astrophysics Data System (ADS)

    Giuliani, Matteo; Herman, Jonathan D.; Castelletti, Andrea; Reed, Patrick M.

    2014-05-01

    Current water reservoir operating policies are facing growing water demands as well as increasing uncertainties associated with a changing climate. However, policy inertia and myopia strongly limit the possibility of adapting current water reservoir operations to the undergoing change. Historical agreements and regulatory constraints limit the rate that reservoir operations are innovated and creates policy inertia, where water institutions are unlikely to change their current practices in absence of dramatic failures. Yet, no guarantee exists that historical management policies will not fail in coming years. In reference to policy myopia, although it has long been recognized that water reservoir systems are generally framed in heterogeneous socio-economic contexts involving a myriad of conflicting, non-commensurable operating objectives, the broader understanding of the multi-objective consequences of current operating rules as well as their vulnerability to hydroclimatic uncertainties is severely limited. This study proposes a decision analytic framework to overcome both policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification, many-objective optimization under uncertainty, and visual analytics to characterize current operations and discover key tradeoffs between alternative policies for balancing evolving demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to the system's competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. The proposed framework initially uses available streamflow observations to implicitly identify the current but unknown operating policy of Conowingo Dam. The quality of the identified baseline

  15. Managing lifestyle change to reduce coronary risk: a synthesis of qualitative research on peoples’ experiences

    PubMed Central

    2014-01-01

    Background Coronary heart disease is an incurable condition. The only approach known to slow its progression is healthy lifestyle change and concordance with cardio-protective medicines. Few people fully succeed in these daily activities so potential health improvements are not fully realised. Little is known about peoples’ experiences of managing lifestyle change. The aim of this study was to synthesise qualitative research to explain how participants make lifestyle change after a cardiac event and explore this within the wider illness experience. Methods A qualitative synthesis was conducted drawing upon the principles of meta-ethnography. Qualitative studies were identified through a systematic search of 7 databases using explicit criteria. Key concepts were identified and translated across studies. Findings were discussed and diagrammed during a series of audiotaped meetings. Results The final synthesis is grounded in findings from 27 studies, with over 500 participants (56% male) across 8 countries. All participants experienced a change in their self-identity from what was ‘familiar’ to ‘unfamiliar’. The transition process involved ‘finding new limits and a life worth living’ , ‘finding support for self’ and ‘finding a new normal’. Analyses of these concepts led to the generation of a third order construct, namely an ongoing process of ‘reassessing past, present and future lives’ as participants considered their changed identity. Participants experienced a strong urge to get back to ‘normal’. Support from family and friends could enable or constrain life change and lifestyle changes. Lifestyle change was but one small part of a wider ‘life’ change that occurred. Conclusions The final synthesis presents an interpretation, not evident in the primary studies, of a person-centred model to explain how lifestyle change is situated within ‘wider’ life changes. The magnitude of individual responses to a changed health status

  16. Reducing Gridlock on the Grid: Utility Trends in Managing Peak Electric Load through Residential Demand Response

    NASA Astrophysics Data System (ADS)

    McDonald, Betsy

    Utilities across the United States are piloting residential demand response programs to help manage peak electric demand. Using publicly available program evaluations, this thesis analyzes nine such programs to uncover and synthesize the range of program offerings, goals, enrollment strategies, and customer experiences. This review reveals that program participation, components, and results differ based on a variety of factors, including geographic characteristics, program goals, and implementation strategies. The diversity of program designs and evaluation findings suggests an underlying tension between the need to generate cost-effective program impacts and the desire to increase accessibility so that program benefits are not exclusive to certain segments of the population. For more significant and impactful engagement, program goals may need to shift. State level policy support could help shift program goals toward increasing program accessibility. Future research should explore creative strategies that target existing barriers and allow for more inclusive deployment.

  17. Strategic risk management: reducing malpractice claims through more effective patient-doctor communication.

    PubMed

    Virshup, B B; Oppenberg, A A; Coleman, M M

    1999-01-01

    Many malpractice suits are brought not because of malpractice nor even because of complaints about the quality of medical care but as an expression of anger about some aspect of patient-doctor relationships and communications. The theory presented is that under the stress of anxiety and physical illness, some patients regress to childhood needs; physicians are not generally trained to fill such needs. Thus, these patients, angry because of this, express their anger in malpractice suits. This theory has been taught to physicians and medical students as part of a physician continuing medical education (CME) seminar on Loss Prevention/Risk Management through demonstration of active-listening techniques to seminar participants. Physicians who understand and can respond appropriately to the emotional needs of their patients are less likely to be sued. This may also translate into a more fulfilled practice of medicine by those physicians who are most aware of the importance of a positive relationship. PMID:10452132

  18. Reducing input data via image categorization to improve the speed of copyright content management systems

    NASA Astrophysics Data System (ADS)

    Ikeda, Kanami; Watanabe, Eriko

    2015-02-01

    An optical correlator has the advantage of high data transfer speed and parallel operation. However, in copyright content management systems (CCMSs), the numerous video files that need to be downloaded from the Internet and input to the optical correlator constitute a bottleneck. This paper proposes an image categorization method for CCMSs that uses the difference in the color features between animation and live-action images to remove this bottleneck and increase the speed of CCMSs. The results of experiments conducted indicate that the proposed method achieves a live-action video true rejection rate of 86.7 % and an animation video false rejection rate of 13.3 %. This indicates that the proposed method can improve the overall speed of a CCMS more than twice the original speed.

  19. Reducing the economic burden in management of Guillain–Barre syndrome using modified plasmapheresis

    PubMed Central

    Iyer, Rekha Ramaswamy; Shah, Pragnesh Hasmukhlal; Roy, Sher Sankar K.; Suri, Sushil Kumar Kundanlal

    2016-01-01

    Background: Guillain–Barre syndrome (GBS) is an autoimmune acute inflammatory demyelinating polyneuropathy affecting the peripheral nervous system treated with high-dose immunoglobulin, physical therapy, or plasmapheresis. Immunoglobulins are expensive and even plasmapheresis might not be affordable to patients visiting government set-ups. Aims: This study was undertaken to emphasize the efficacy of plasmapheresis in treatment of adult GBS patients and to narrate methods of reducing the economic burden in the treatment of these patients using modified plasmapheresis. Methods: A study was conducted on 12 adult GBS patients at Sir Takhtasinhji General Hospital, Bhavnagar from July 2012 to July 2014. Patients were assessed on a 6-point disability scale. They were treated with plasmapheresis over 10 days with REF627 kit from Haemonetics Corporation Limited on MCS+ machine. Improvement was noted by the change in the disability scale score and expenses of various modes of treatment were also considered. Results: Seventy-five percent showed improvement at the end of the treatment. The cost of modified plasmapheresis was Rs. 8000/cycle, i.e., Rs. 40,000/patient. Conclusion: Plasmapheresis along with proper supportive measures is a more cost-effective efficacious mode of therapy in adult patients of GBS. Further, modified plasmapheresis using REF627 kit and 6% hexastarch as replacement fluid on MCS+ apheresis machine reduces the cost of therapy for poor patients visiting government set-ups. PMID:27605847

  20. Medical alert management: a real-time adaptive decision support tool to reduce alert fatigue.

    PubMed

    Lee, Eva K; Wu, Tsung-Lin; Senior, Tal; Jose, James

    2014-01-01

    With the adoption of electronic medical records (EMRs), drug safety alerts are increasingly recognized as valuable tools for reducing adverse drug events and improving patient safety. However, even with proper tuning of the EMR alert parameters, the volume of unfiltered alerts can be overwhelming to users. In this paper, we design an adaptive decision support tool in which past cognitive overriding decisions of users are learned, adapted and used for filtering actions to be performed on current alerts. The filters are designed and learned based on a moving time window, number of alerts, overriding rates, and monthly overriding fluctuations. Using alerts from two separate years to derive filters and test performance, predictive accuracy rates of 91.3%-100% are achieved. The moving time window works better than a static training approach. It allows continuous learning and capturing of the most recent decision characteristics and seasonal variations in drug usage. The decision support system facilitates filtering of non-essential alerts and adaptively learns critical alerts and highlights them prominently to catch providers' attention. The tool can be plugged into an existing EMR system as an add-on, allowing real-time decision support to users without interfering with existing EMR functionalities. By automatically filtering the alerts, the decision support tool mitigates alert fatigue and allows users to focus resources on potentially vital alerts, thus reducing the occurrence of adverse drug events. PMID:25954391

  1. A Community Hospital-County Health Department Partnership to Reduce Preventable Readmissions: Lessons Learned for Population Health Management.

    PubMed

    Kurtzman, Jordan H

    2015-01-01

    Healthcare reform has prompted hospital executives to adopt new strategies aimed at population health management. Research regarding the broad determinants of health suggests that if hospitals are to build successful population health management models, they must engage in collaborative partnerships with a variety of community stakeholders. In this report, the author describes a collaborative partnership between a community hospital and a county health department to reduce preventable readmissions. This program illustrates the important role that health information technology (HIT), managerial systems, new processes, and hospital culture play in collaborations with external parties. On a larger scale, these facilitators are key factors in developing population health business models such as accountable care organizations. A sound hospital infrastructure should be supported by hospital leaders and staff who are held accountable for community initiatives and communicate transparently with external partners. PMID:26364349

  2. Modelling the benefits of flood emergency management measures in reducing damages: a case study on Sondrio, Italy

    NASA Astrophysics Data System (ADS)

    Molinari, D.; Ballio, F.; Menoni, S.

    2013-08-01

    The European "Floods Directive" 2007/60/EU has produced an important shift from a traditional approach to flood risk management centred only on hazard analysis and forecast to a newer one which encompasses other aspects relevant to decision-making and which reflect recent research advances in both hydraulic engineering and social studies on disaster risk. This paper accordingly proposes a way of modelling the benefits of flood emergency management interventions calculating the possible damages by taking into account exposure, vulnerability, and expected damage reduction. The results of this model can be used to inform decisions and choices for the implementation of flood emergency management measures. A central role is played by expected damages, which are the direct and indirect consequence of the occurrence of floods in exposed and vulnerable urban systems. How damages should be defined and measured is a key question that this paper tries to address. The Floods Directive suggests that mitigation measures taken to reduce flood impact need to be evaluated also by means of a cost-benefit analysis. The paper presents a methodology for assessing the effectiveness of early warning for flash floods, considering its potential impact in reducing direct physical damage, and it assesses the general benefit in regard to other types of damages and losses compared with the emergency management costs. The methodology is applied to the case study area of the city of Sondrio in the northern Alpine region of Italy. A critical discussion follows the application. Its purpose is to highlight the strengths and weaknesses of available models for quantifying direct physical damage and of the general model proposed, given the current state of the art in damage and loss assessment.

  3. Different causes of reduced sensitivity to thyroid hormone: diagnosis and clinical management.

    PubMed

    Visser, W Edward; van Mullem, Alies A A; Visser, Theo J; Peeters, Robin P

    2013-11-01

    Normal thyroid hormone (TH) metabolism and action require adequate cellular TH signalling. This entails proper function of TH transporters in the plasma membrane, intracellular deiodination of TH and action of the bioactive hormone T3 at its nuclear receptors (TRs). The present review summarizes the discoveries of different syndromes with reduced sensitivity at the cellular level. Mutations in the TH transporter MCT8 cause psychomotor retardation and abnormal thyroid parameters. Mutations in the SBP2 protein, which is required for normal deiodination, give rise to a multisystem disorder including abnormal thyroid function tests. Mutations in TRβ1 are a well-known cause of resistance to TH with mostly a mild phenotype, while only recently, patients with mutations in TRα1 were identified. The latter patients have slightly abnormal TH levels, growth retardation and cognitive defects. This review will describe the mechanisms of disease, clinical phenotype, diagnostic testing and suggestions for treatment strategies for each of these syndromes. PMID:23834164

  4. Exploiting Co-Benefits of Increased Rice Production and Reduced Greenhouse Gas Emission through Optimized Crop and Soil Management.

    PubMed

    An, Ning; Fan, Mingsheng; Zhang, Fusuo; Christie, Peter; Yang, Jianchang; Huang, Jianliang; Guo, Shiwei; Shi, Xiaojun; Tang, Qiyuan; Peng, Jianwei; Zhong, Xuhua; Sun, Yixiang; Lv, Shihua; Jiang, Rongfeng; Dobermann, Achim

    2015-01-01

    Meeting the future food security challenge without further sacrificing environmental integrity requires transformative changes in managing the key biophysical determinants of increasing agronomic productivity and reducing the environmental footprint. Here, we focus on Chinese rice production and quantitatively address this concern by conducting 403 on-farm trials across diverse rice farming systems. Inherent soil productivity, management practices and rice farming type resulted in confounded and interactive effects on yield, yield gaps and greenhouse gas (GHG) emissions (N2O, CH4 and CO2-equivalent) with both trade-offs and compensating effects. Advances in nitrogen, water and crop management (Best Management Practices-BMPs) helped closing existing yield gaps and resulted in a substantial reduction in CO2-equivalent emission of rice farming despite a tradeoff of increase N2O emission. However, inherent soil properties limited rice yields to a larger extent than previously known. Cultivating inherently better soil also led to lower GHG intensity (GHG emissions per unit yield). Neither adopting BMPs only nor improving soils with low or moderate productivity alone can adequately address the challenge of substantially increasing rice production while reducing the environmental footprint. A combination of both represents the most efficient strategy to harness the combined-benefits of enhanced production and mitigating climate change. Extrapolating from our farm data, this strategy could increase rice production in China by 18%, which would meet the demand for direct human consumption of rice by 2030. It would also reduce fertilizer nitrogen consumption by 22% and decrease CO2-equivalent emissions during the rice growing period by 7% compared with current farming practice continues. Benefits vary by rice-based cropping systems. Single rice systems have the largest food provision benefits due to its wider yield gap and total cultivated area, whereas double-rice system

  5. Exploiting Co-Benefits of Increased Rice Production and Reduced Greenhouse Gas Emission through Optimized Crop and Soil Management

    PubMed Central

    An, Ning; Fan, Mingsheng; Zhang, Fusuo; Christie, Peter; Yang, Jianchang; Huang, Jianliang; Guo, Shiwei; Shi, Xiaojun; Tang, Qiyuan; Peng, Jianwei; Zhong, Xuhua; Sun, Yixiang; Lv, Shihua; Jiang, Rongfeng; Dobermann, Achim

    2015-01-01

    Meeting the future food security challenge without further sacrificing environmental integrity requires transformative changes in managing the key biophysical determinants of increasing agronomic productivity and reducing the environmental footprint. Here, we focus on Chinese rice production and quantitatively address this concern by conducting 403 on-farm trials across diverse rice farming systems. Inherent soil productivity, management practices and rice farming type resulted in confounded and interactive effects on yield, yield gaps and greenhouse gas (GHG) emissions (N2O, CH4 and CO2-equivalent) with both trade-offs and compensating effects. Advances in nitrogen, water and crop management (Best Management Practices—BMPs) helped closing existing yield gaps and resulted in a substantial reduction in CO2-equivalent emission of rice farming despite a tradeoff of increase N2O emission. However, inherent soil properties limited rice yields to a larger extent than previously known. Cultivating inherently better soil also led to lower GHG intensity (GHG emissions per unit yield). Neither adopting BMPs only nor improving soils with low or moderate productivity alone can adequately address the challenge of substantially increasing rice production while reducing the environmental footprint. A combination of both represents the most efficient strategy to harness the combined-benefits of enhanced production and mitigating climate change. Extrapolating from our farm data, this strategy could increase rice production in China by 18%, which would meet the demand for direct human consumption of rice by 2030. It would also reduce fertilizer nitrogen consumption by 22% and decrease CO2-equivalent emissions during the rice growing period by 7% compared with current farming practice continues. Benefits vary by rice-based cropping systems. Single rice systems have the largest food provision benefits due to its wider yield gap and total cultivated area, whereas double-rice system

  6. Why are employers prodding health-care providers to adopt new management systems?: reducing the cost of health care.

    PubMed

    De Feo, Joseph A

    2004-01-01

    Increasingly concerned about the escalating costs of health-care insurance coverage, the quality of health-care delivery, and the escalating costs of delivering clinical services, employers are taking action. They are prodding health-care providers and insurers to adopt breakthrough management systems aimed at reducing costs related to poorly performing services and processes--and at the same time improving clinical outcomes. Doing this will require all members of the health-care value chain to work together to improve each and every process and procedure, whether clinical or administrative. This development presents formidable challenges to all health-care providers, insurers, employees, and patients. PMID:15085703

  7. Potential for reduced methane and carbon dioxide emissions from livestock and pasture management in the tropics

    PubMed Central

    Thornton, Philip K.; Herrero, Mario

    2010-01-01

    We estimate the potential reductions in methane and carbon dioxide emissions from several livestock and pasture management options in the mixed and rangeland-based production systems in the tropics. The impacts of adoption of improved pastures, intensifying ruminant diets, changes in land-use practices, and changing breeds of large ruminants on the production of methane and carbon dioxide are calculated for two levels of adoption: complete adoption, to estimate the upper limit to reductions in these greenhouse gases (GHGs), and optimistic but plausible adoption rates taken from the literature, where these exist. Results are expressed both in GHG per ton of livestock product and in Gt CO2-eq. We estimate that the maximum mitigation potential of these options in the land-based livestock systems in the tropics amounts to approximately 7% of the global agricultural mitigation potential to 2030. Using historical adoption rates from the literature, the plausible mitigation potential of these options could contribute approximately 4% of global agricultural GHG mitigation. This could be worth on the order of $1.3 billion per year at a price of $20 per t CO2-eq. The household-level and sociocultural impacts of some of these options warrant further study, however, because livestock have multiple roles in tropical systems that often go far beyond their productive utility. PMID:20823225

  8. Managing Errors to Reduce Accidents in High Consequence Networked Information Systems

    SciTech Connect

    Ganter, J.H.

    1999-02-01

    Computers have always helped to amplify and propagate errors made by people. The emergence of Networked Information Systems (NISs), which allow people and systems to quickly interact worldwide, has made understanding and minimizing human error more critical. This paper applies concepts from system safety to analyze how hazards (from hackers to power disruptions) penetrate NIS defenses (e.g., firewalls and operating systems) to cause accidents. Such events usually result from both active, easily identified failures and more subtle latent conditions that have resided in the system for long periods. Both active failures and latent conditions result from human errors. We classify these into several types (slips, lapses, mistakes, etc.) and provide NIS examples of how they occur. Next we examine error minimization throughout the NIS lifecycle, from design through operation to reengineering. At each stage, steps can be taken to minimize the occurrence and effects of human errors. These include defensive design philosophies, architectural patterns to guide developers, and collaborative design that incorporates operational experiences and surprises into design efforts. We conclude by looking at three aspects of NISs that will cause continuing challenges in error and accident management: immaturity of the industry, limited risk perception, and resource tradeoffs.

  9. Reducing the risk of invasive forest pests and pathogens: Combining legislation, targeted management and public awareness.

    PubMed

    Klapwijk, Maartje J; Hopkins, Anna J M; Eriksson, Louise; Pettersson, Maria; Schroeder, Martin; Lindelöw, Åke; Rönnberg, Jonas; Keskitalo, E Carina H; Kenis, Marc

    2016-02-01

    Intensifying global trade will result in increased numbers of plant pest and pathogen species inadvertently being transported along with cargo. This paper examines current mechanisms for prevention and management of potential introductions of forest insect pests and pathogens in the European Union (EU). Current European legislation has not been found sufficient in preventing invasion, establishment and spread of pest and pathogen species within the EU. Costs associated with future invasions are difficult to estimate but past invasions have led to negative economic impacts in the invaded country. The challenge is combining free trade and free movement of products (within the EU) with protection against invasive pests and pathogens. Public awareness may mobilise the public for prevention and detection of potential invasions and, simultaneously, increase support for eradication and control measures. We recommend focus on commodities in addition to pathways, an approach within the EU using a centralised response unit and, critically, to engage the general public in the battle against establishment and spread of these harmful pests and pathogens. PMID:26744056

  10. Chronotherapy with conventional blood pressure medications improves management of hypertension and reduces cardiovascular and stroke risks.

    PubMed

    Hermida, Ramón C; Ayala, Diana E; Smolensky, Michael H; Fernández, José R; Mojón, Artemio; Portaluppi, Francesco

    2016-05-01

    Correlation between blood pressure (BP) and target organ damage, vascular risk and long-term patient prognosis is greater for measurements derived from around-the-clock ambulatory BP monitoring than in-clinic daytime ones. Numerous studies consistently substantiate the asleep BP mean is both an independent and a much better predictor of cardiovascular disease (CVD) risk than either the awake or 24 h means. Sleep-time hypertension is much more prevalent than suspected, not only in patients with sleep disorders, but also among those who are elderly or have type 2 diabetes, chronic kidney disease or resistant hypertension. Hence, cost-effective adequate control of sleep-time BP is of marked clinical relevance. Ingestion time, according to circadian rhythms, of hypertension medications of six different classes and their combinations significantly affects BP control, particularly sleep-time BP, and adverse effects. For example, because the high-amplitude circadian rhythm of the renin-angiotensin-aldosterone system activates during nighttime sleep, bedtime vs. morning ingestion of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers better reduces the asleep BP mean, with additional benefit, independent of medication terminal half-life, of converting the 24 h BP profile into more normal dipper patterning. The MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares) study, first prospective randomized treatment-time investigation designed to test the worthiness of bedtime chronotherapy with ⩾1 conventional hypertension medications so as to specifically target attenuation of asleep BP, demonstrated, relative to conventional morning therapy, 61% reduction of total CVD events and 67% decrease of major CVD events, that is, CVD death, myocardial infarction, and ischemic and hemorrhagic stroke. The MAPEC study, along with other earlier conducted less refined trials, documents the asleep BP mean is the most significant

  11. Alternate Wetting and Drying as an Effective Management Practice to Reduce Methane in Arkansas Rice Production

    NASA Astrophysics Data System (ADS)

    Runkle, B.; Smith, S. F.; Suvocarev, K.; Reba, M. L.

    2015-12-01

    Approximately 15% of the global 308 Tg CH4 emitted by anthropogenic sources is currently attributed to rice cultivation. Arkansas, the leading state in rice cultivation, produces over 42% of the total rice and represents over 43% of total land planted to rice in the US. Although rice production is generally water-intensive, some rice producers have adopted a conservation practice, 'Alternate Wetting and Drying' (AWD), in which the flood is released periodically during the growing season. In addition, implementing AWD can reduce CH4 emissions though the introduction of aerobic conditions. To assess the magnitude of this reduction, conventionally flooded (CONV) and AWD fields were identically instrumented for the 2015 season and fluxes of CH4 were measured with an open path IRGA. Other biophysical variables were monitored to determine the relative dominance of potential drivers. Half-hourly CH4 fluxes from the AWD and CONV fields during their similar initial flood (DOY 138-161) were well correlated (R2 = 0.762), indicating similar mechanisms controlling CH4 emissions in both fields. After the initial drydown event in the AWD field (162 DOY), daily median CH4 fluxes continued to rise to 7.80 mg CH4 m-2 h-1 on 163 DOY before subsiding to a local minimum of 0.162 mg CH4 m-2 h-1 on 171 DOY. Daily median CH4 fluxes between 9.24 and 16.0 mg CH4 m-2 h-1 were observed in the CONV field during this same period. Cumulative emissions from both fields following the drydown event and prior to rewetting demonstrated a reduction in CH4 emissions by the AWD treatment by 82%. The substantial decrease in CH4 emissions by AWD in the early growing season supports and expands upon previous chamber-based research and offers strong evidence for the efficacy of AWD in reducing CH4 emissions in AR rice production. The presentation will also assess the latter portion of the growing season, currently underway, and will provide process-based relationships between biophysical parameters and CH

  12. Managing population immunity to reduce or eliminate the risks of circulation following the importation of polioviruses.

    PubMed

    Thompson, Kimberly M; Kalkowska, Dominika A; Duintjer Tebbens, Radboud J

    2015-03-24

    Poliovirus importations into polio-free countries represent a major concern during the final phases of global eradication of wild polioviruses (WPVs). We extend dynamic transmission models to demonstrate the dynamics of population immunity out through 2020 for three countries that only used inactivated poliovirus vaccine (IPV) for routine immunization: the US, Israel, and The Netherlands. For each country, we explore the vulnerability to re-established transmission following an importation for each poliovirus serotype, including the impact of immunization choices following the serotype 1 WPV importation that occurred in 2013 in Israel. As population immunity declines below the threshold required to prevent transmission, countries become at risk for re-established transmission. Although importations represent stochastic events that countries cannot fully control because people cross borders and polioviruses mainly cause asymptomatic infections, countries can ensure that any importations die out. Our results suggest that the general US population will remain above the threshold for transmission through 2020. In contrast, Israel became vulnerable to re-established transmission of importations of live polioviruses by the late 2000s. In Israel, the recent WPV importation and outbreak response use of bivalent oral poliovirus vaccine (bOPV) eliminated the vulnerability to an importation of poliovirus serotypes 1 and 3 for several years, but not serotype 2. The Netherlands experienced a serotype 1 WPV outbreak in 1992-1993 and became vulnerable to re-established transmission in religious communities with low vaccine acceptance around the year 2000, although the general population remains well-protected from widespread transmission. All countries should invest in active management of population immunity to avoid the potential circulation of imported live polioviruses. IPV-using countries may wish to consider prevention opportunities and/or ensure preparedness for response

  13. Potential for Improvement in Cancer Management: Reducing Mortality in the European Union

    PubMed Central

    Rota, Matteo; Malvezzi, Matteo; Negri, Eva

    2015-01-01

    Overall age-standardized cancer mortality rates in the European Union (EU) have declined by approximately 20% through 2010 (17% in women, 22% in men) since the peak value reached in 1988. This corresponds to the avoidance of more than 250,000 cancer deaths in 2010 alone and approximately 2.2 million deaths over the 1989–2010 22-year period. A more than twofold difference remains between the highest cancer mortality rates (in Hungary and other central European countries) and the lowest (in selected Nordic countries and Switzerland). Part of this gap is due to tobacco, alcohol, and other lifestyle and environmental exposures, and another part is attributable to differences in cancer diagnosis, treatment, and management. There are also appreciable differences in 5-year cancer survival across the EU, with lower survival rates in central and eastern Europe. If overall cancer survival in EU countries with low rates could be raised to the median, approximately 50,000 additional cancer deaths would be avoided per year, and more than 100,000 would be avoided if overall survival in all countries were at least that of the 75% percentile—4% and 8%, respectively, of the approximately 1.3 million cancer deaths registered in the EU in 2010. There is, however, substantial uncertainty about any such estimate because differences in cancer survival are partly or largely attributable to earlier diagnosis, in variable proportion for each cancer site and probably to different degrees in different countries, even in the absence of changes in the date of death or avoidance of death. Consequently, these approximations are the best available and may be used cautiously to compare countries, health care approaches, and changes that occur over time. PMID:25888268

  14. Reducing stroke in women with risk factor management: blood pressure and cholesterol.

    PubMed

    Baghshomali, Sanam; Bushnell, Cheryl

    2014-09-01

    Stroke is a major cause of death and disability in adults worldwide. Prevention focused on modifiable risk factors, such as hypertension and hyperlipidemia, has shown them to be of significant importance in decreasing the risk of stroke. Multiple studies have brought to light the differences between men and women with regards to stroke and these risk factors. Women have a higher prevalence of stroke, mortality and disability and it has been shown that preventive and treatment options are not as comprehensive for women. Hence, it is of great necessity to evaluate and summarize the differences in gender and stroke risk factors in order to target disparities and optimize prevention, especially because women have a higher lifetime risk of stroke. The purpose of this review is to summarize sex differences in the prevalence of hypertension and hyperlipidemia. In addition, we will review the sex differences in stroke prevention effectiveness and adherence to blood pressure and cholesterol medications, and suggest future directions for research to reduce the burden of stroke in women. PMID:25335544

  15. Water management reduces greenhouse gas emissions in a Mediterranean rice paddy field

    NASA Astrophysics Data System (ADS)

    Gruening, Carsten; Meijide, Ana; Manca, Giovanni; Goded, Ignacio; Seufert, Guenther; Cescatti, Alessandro

    2016-04-01

    Rice paddy fields are one of the biggest anthropogenic sources of methane (CH4), the second most important greenhouse gas (GHG) after carbon dioxide (CO2). Therefore most studies on greenhouse gases (GHG) in these agricultural systems focus on the evaluation of CH4 production. However, there are other GHGs such as CO2 and nitrous oxide (N2O) also exchanged within the atmosphere. Since each of the GHGs has its own radiative forcing effect, the total GHG budget of rice cultivation and its global warming potential (GWP) must be assessed. For this purpose a field experiment was carried out in a Mediterranean rice paddy field in the Po Valley (Italy), the largest rice producing region in Europe. Ecosystem CO2 and CH4 fluxes were assessed using the eddy covariance technique, while soil respiration and soil CH4 and N2O fluxes were measured with closed chambers for two complete years. Combining all GHGs measured, the rice paddy field acted as a sink of -368 and -828 g CO2 eq m-2 year-1 in the first and second years respectively. Both years, it was a CO2 sink and a CH4 source, while the N2O contribution to the GWP was relatively small. Differences in the GHG budget between the two years of measurements were mainly caused by the greater CH4 emissions in the first year (37.4 g CH4 m-2 compared to 21.03 g CH4 m-2 in the second year), probably as a consequence of the drainage of the water table in the middle of the growing season during the second year, which resulted in lower CH4 emissions without significant increases of N2O and CO2 fluxes. However, midseason drainage also resulted in small decreases of yield, indicating that GHG budget studies from agricultural systems should consider carbon exports through the harvest. The balance between net GWP and carbon yield indicated a loss of carbon equivalents from the system, which was more than 30-fold higher in the first year. Our results therefore suggest that an adequate management of the water table has the potential to be an

  16. Complication Reducing Effect of the Information Technology-Based Diabetes Management System on Subjects with Type 2 Diabetes

    PubMed Central

    Cho, Jae-Hyoung; Lee, Jin-Hee; Oh, Jeong-Ah; Kang, Mi-Ja; Choi, Yoon-Hee; Kwon, Hyuk-Sang; Chang, Sang-Ah; Cha, Bong-Yun; Son, Ho-Young; Yoon, Kun-Ho

    2008-01-01

    Objective We introduced a new information technology-based diabetes management system, called the Internet-based glucose monitoring system (IBGMS), and demonstrated its short-term and long-term favorable effects. However, there has been no report on clinical effects of such a new diabetes management system on the development of diabetic complications so far. This study was used to simulate the complication reducing effect of the IBGMS, given in addition to existing treatments in patients with type 2 diabetes. Research Design and Methods The CORE Diabetes Model, a peer-reviewed, published, validated computer simulation model, was used to project long-term clinical outcomes in type 2 diabetes patients receiving the IBGMS in addition to their existing treatment. The model combined standard Markov submodels to simulate the incidence and progression of diabetes-related complications. Results The addition of IBGMS was associated with improvements in reducing diabetic complications, mainly microangiopathic complications, including diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, and diabetic foot ulcer. The IBGMS also delayed the development of all diabetic complications for more than 1 year. Conclusions This study demonstrated that the simulated IBGMS, compared to existing treatment, was associated with a reduction of diabetic complications. As a result, it provides valuable evidence for practical application to the public in the world. PMID:19885180

  17. Maintaining yields and reducing nitrogen loss in rice-wheat rotation system in Taihu Lake region with proper fertilizer management

    NASA Astrophysics Data System (ADS)

    Xue, Lihong; Yu, Yingliang; Yang, Linzhang

    2014-11-01

    In the Tailake region of China, heavy nitrogen (N) loss of rice-wheat rotation systems, due to high fertilizer-N input with low N use efficiency (NUE), was widely reported. To alleviate the detrimental impacts caused by N loss, it is necessary to improve the fertilizer management practices. Therefore, a 3 yr field experiments with different N managements including organic combined chemical N treatment (OCN, 390 kg N ha-1 yr-1, 20% organic fertilizer), control-released urea treatment (CRU, 390 kg N ha-1 yr-1, 70% resin-coated urea), reduced chemical N treatment (RCN, 390 kg N ha-1 yr-1, all common chemical fertilizer), and site-specific N management (SSNM, 333 kg N ha-1 yr-1, all common chemical fertilizer) were conducted in the Taihu Lake region with the ‘farmer’s N’ treatment (FN, 510 kg N ha-1 yr-1, all common chemical fertilizer) as a control. Grain yield, plant N uptake (PNU), NUE, and N losses via runoff, leaching, and ammonia volatilization were assessed. In the rice season, the FN treatment had the highest N loss and lowest NUE, which can be attributed to an excessive rate of N application. Treatments of OCN and RCN with a 22% reduced N rate from FN had no significant effect on PNU nor the yield of rice in the 3 yr; however, the NUE was improved and N loss was reduced 20-32%. OCN treatment achieved the highest yield, while SSNM has the lowest N loss and highest NUE due to the lowest N rate. In wheat season, N loss decreased about 28-48% with the continuous reduction of N input, but the yield also declined, with the exception of OCN treatment. N loss through runoff, leaching and ammonia volatilization was positively correlated with the N input rate. When compared with the pure chemical fertilizer treatment of RCN under the same N input, OCN treatment has better NUE, better yield, and lower N loss. 70% of the urea replaced with resin-coated urea had no significant effect on yield and NUE improvement, but decreased the ammonia volatilization loss. Soil

  18. Innovative Water Management Technology to Reduce Environment Impacts of Produced Water

    SciTech Connect

    Castle, James; Rodgers, John; Alley, Bethany; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael

    2013-05-15

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or footprint of a full-size CWTS for a given inflow rate of produced water.

  19. Innovative Water Management Technology to Reduce Environmental Impacts of Produced Water

    SciTech Connect

    Castle, James; Rodgers, John; Alley, Bethany; Beebe, Alex; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael

    2013-05-15

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or ?footprint? of a full-size CWTS for a given inflow rate of produced water.

  20. Innovative Water Management Technology to Reduce Environment Impacts of Produced Water

    SciTech Connect

    Castle, James W.; Rodgers, John H.; Alley, Bethany; Beebe, Alex; Coffey, Ruthanne; Jurinko, Kristen; Pardue, Michael; Ritter, Tina; Spacil, Michael M.

    2013-08-08

    -reverse osmosis produced water was designed to promote oxidizing conditions within the first wetland cell for nitrification of ammonia, and the subsequent three cells were designed to promote reducing conditions for denitrification of nitrate. By incorporating multiple wetland cells in a CWTS, the conditions within each cell can be modified for removal of specific COCs. In addition, a CWTS designed with multiple cells allows for convenient sample collection points so that biogeochemical conditions of individual cells can be monitored and performance evaluated. Removal rate coefficients determined from the pilot-scale CWTS experiments and confirmed by the demonstration system can be used to calculate HRTs required to treat COCs in full-scale CWTSs. The calculated HRTs can then be used to determine the surface area or footprint of a full-size CWTS for a given inflow rate of produced water.

  1. A cross-sectional pilot study to examine food sufficiency and assess nutrition among low-income patients with injection-related venous ulcers.

    PubMed

    Pieper, Barbara; Templin, Thomas N

    2015-04-01

    Adequate nutrition has long been considered a critical component for wound healing, but literature regarding the relationship between nutrition and venous ulcer (VU) healing is limited. A person's nutrition is affected by the availability of food as well as his/her overall health. Food sufficiency and nutrition are important concerns in the care of persons of low income with injection-related VUs, which tend to be large and slow to heal. A cross-sectional pilot study was conducted to explore the relationship between food sufficiency/security and nutrition with regard to demographic, wound, quality-of-life, physical activity, falls, and fall risk variables. Nutrition was examined using 2 well-developed instruments that measure food sufficiency/security and assess nutrition--the United States Department of Agriculture's Adult Food Sufficiency Questionnaire (FSQ) and the Nestle Mini Nutritional Assessment (MNA). All participants (N = 31, 54% men, mean age 56.1 ± 3.6 years, all African American) were recruited from an outpatient clinic. All had injection-related VUs from a history of injecting illicit substances. In terms of food sufficiency/security, most participants (26, 84%) reported having enough food in the house, but 10 (32%) worried about running out of food. From 16% to 22.6% of participants expressed concern with food sufficiency/security in terms of cutting meal size, eating less, hunger, and weight loss. Food sufficiency/security was high for 19 (61.3%), but 12 (39%) had marginal or lower food sufficiency/security. MNA scores showed 16 participants (52%) were at risk of malnutrition or malnourished. Low food sufficiency/security was significantly (P <0.05) associated with less motivation for activity (r = -0.40) and less walking (r = -0.36). Better nutrition assessment scores were significantly associated (P <0.01) with fewer comorbidities (r = -0.57) and falls (r = -0.46) and with higher quality of life (r = 0.50), motivation for physical activity (r = 0

  2. Reducing psychosocial risks through supervisors' development: a contribution for a brief version of the "Stress Management Competency Indicator Tool".

    PubMed

    Toderi, Stefano; Gaggia, Andrea; Balducci, Cristian; Sarchielli, Guido

    2015-06-15

    With the recent changes in the world of work psychosocial risks are increasingly prevalent, causing work stress and physical and mental illnesses, which have a tremendous impact on public health and social participation. Supervisors' behaviour development was proposed as an innovative intervention that can reduce psychosocial risks. The "Stress Management Competency Indicator Tool" is one of the most important questionnaires that assess managers' preventive behaviour. However, its psychometric properties have never been evaluated and the length of the questionnaire (66 items) limits its practical applicability. The aim of this study was to contribute to the development of the questionnaire by providing psychometric evidence on a brief version of the tool focusing on the "Managing and Communicating existing and future Work" cluster of behaviours, which has been found to be the crucial one in terms of stress prevention. A questionnaire was administered to 178 employees of two Italian public organizations (a municipality and a hospital), measuring the supervisors' "Managing and Communicating existing and future Work" competency, and the affective well-being and work team effectiveness. The results showed excellent psychometric properties of the supervisors' behaviour scale and confirmed the expected relationships with criterion outcomes (affective well-being and team effectiveness). Overall, the factorial structure and dimensionality, the construct validity and reliability, and the concurrent validity of the tool were strongly supported by this study. We concluded that the brief version of the scale is a valid and reliable measure that can be easily used in practice and that can contribute to the development of research and practice on this topic. PMID:25770947

  3. Use of drinking water treatment residuals as a potential best management practice to reduce phosphorus risk index scores.

    PubMed

    Dayton, E A; Basta, N T

    2005-01-01

    The P risk index system has been developed to identify agricultural fields vulnerable to P loss as a step toward protecting surface water. Because of their high Langmuir phosphorus adsorption maxima (P(max)), use of drinking water treatment residuals (WTRs) should be considered as a best management practice (BMP) to lower P risk index scores. This work discusses three WTR application methods that can be used to reduce P risk scores: (i) enhanced buffer strip, (ii) incorporation into a high soil test phosphorus (STP) soil, and (iii) co-blending with manure or biosolids. The relationship between WTR P(max) and reduction in P extractability and runoff P was investigated. In a simulated rainfall experiment, using a buffer strip enhanced with 20 Mg WTR ha(-1), runoff P was reduced by from 66.8 to 86.2% and reductions were related to the WTR P(max). When 25 g kg(-1) WTR was incorporated into a high STP soil of 315 mg kg(-1) determined using Mehlich-3 extraction, 0.01 M calcium chloride-extractable phosphorus (CaCl(2)-P) reductions ranged from 60.9 to 96.0% and were strongly (P < 0.01) related to WTR P(max). At a 100 g kg(-1) WTR addition, Mehlich 3-extractable P reductions ranged from 41.1 to 86.7% and were strongly (P < 0.01) related to WTR P(max). Co-blending WTR at 250 g kg(-1) to manure or biosolids reduced CaCl(2)-P by >75%. The WTR P(max) normalized across WTR application rates (P(max) x WTR application) was significantly related to reductions in CaCl(2)-P or STP. Using WTR as a P risk index modifying factor will promote effective use of WTR as a BMP to reduce P loss from agricultural land. PMID:16275711

  4. Can a supported self-management program for COPD upon hospital discharge reduce readmissions? A randomized controlled trial

    PubMed Central

    Johnson-Warrington, Vicki; Rees, Karen; Gelder, Colin; Morgan, Mike D; Singh, Sally J

    2016-01-01

    Introduction Patients with COPD experience exacerbations that may require hospitalization. Patients do not always feel supported upon discharge and frequently get readmitted. A Self-management Program of Activity, Coping, and Education for COPD (SPACE for COPD), a brief self-management program, may help address this issue. Objective To investigate if SPACE for COPD employed upon hospital discharge would reduce readmission rates at 3 months, compared with usual care. Methods This is a prospective, single-blinded, two-center trial (ISRCTN84599369) with participants admitted for an exacerbation, randomized to usual care or SPACE for COPD. Measures, including health-related quality of life and exercise capacity, were taken at baseline (hospital discharge) and at 3 months. The primary outcome measure was respiratory readmission at 3 months. Results Seventy-eight patients were recruited (n=39 to both groups). No differences were found in readmission rates or mortality at 3 months between the groups. Ten control patients were readmitted within 30 days compared to five patients in the intervention group (P>0.05). Both groups significantly improved their exercise tolerance and Chronic Respiratory Questionnaire (CRQ-SR) results, with between-group differences approaching statistical significance for CRQ-dyspnea and CRQ-emotion, in favor of the intervention. The “Ready for Home” survey revealed that patients receiving the intervention reported feeling better able to arrange their life to cope with COPD, knew when to seek help about feeling unwell, and more often took their medications as prescribed, compared to usual care (P<0.05). Conclusion SPACE for COPD did not reduce readmission rates at 3 months above that of usual care. However, encouraging results were seen in secondary outcomes for those receiving the intervention. Importantly, SPACE for COPD appears to be safe and may help prevent readmission with 30 days. PMID:27330284

  5. Effectiveness of a Reduced-Risk Insecticide Based Bed Bug Management Program in Low-Income Housing.

    PubMed

    Singh, Narinderpal; Wang, Changlu; Cooper, Richard

    2013-01-01

    Bed bug (Cimex lectularius L.) infestations are becoming increasingly common in low-income communities. Once they are introduced, elimination is very difficult. As part of the efforts to develop effective and safe bed bug management programs, we conducted a laboratory study evaluating the efficacy of a reduced-risk insecticide-Alpine aerosol (0.5% dinotefuran). We then conducted a field evaluation of a reduced-risk insecticide based integrated pest management (IPM) program in low-income family apartments with young children. In laboratory evaluations, direct spray and 5 min exposure to dry Alpine aerosol residue caused 100.0 ± 0.0 and 91.7 ± 8.3% mortality to bed bug nymphs, respectively. Direct Alpine aerosol spray killed 91.3 ± 4.3% of the eggs. The IPM program included education, steam, bagging infested linens, placing intercepting devices under furniture legs and corners of rooms, applying Alpine aerosol and Alpine dust (0.25% dinotefuran, 95% diatomaceous earth dust), and regularly scheduled monitoring and re-treatment. Nine apartments ranging from 1-1,428 (median: 29) bed bugs based on visual inspection and Climbup interceptor counts were included. Over a 6-month period, an average 172 g insecticide (Alpine aerosol + Alpine dust) was used in each apartment, a 96% reduction in pesticide usage compared to chemical only treatment reported in a similar environment. The IPM program resulted in an average of 96.8 ± 2.2% reduction in the number of bed bugs. However, elimination of bed bugs was only achieved in three lightly infested apartments (<30 bed bugs at the beginning). Elimination success was closely correlated with the level of bed bug populations. PMID:26462533

  6. Can Parental Monitoring and Peer Management Reduce the Selection or Influence of Delinquent Peers? Testing the Question Using a Dynamic Social Network Approach

    ERIC Educational Resources Information Center

    Tilton-Weaver, Lauree C.; Burk, William J.; Kerr, Margaret; Stattin, Håkan

    2013-01-01

    We tested whether parents can reduce affiliation with delinquent peers through 3 forms of peer management: soliciting information, monitoring rules, and communicating disapproval of peers. We examined whether peer management interrupted 2 peer processes: selection and influence of delinquent peers. Adolescents' feelings of being…

  7. Tail biting in pigs--causes and management intervention strategies to reduce the behavioural disorder. A review.

    PubMed

    Sonoda, Lilia Thays; Fels, Michaela; Oczak, Maciej; Vranken, Erik; Ismayilova, Gunel; Guarino, Marcella; Viazzi, Stefano; Bahr, Claudia; Berckmans, Daniel; Hartung, Jörg

    2013-01-01

    One of the largest animal welfare problems in modern pig production is tail biting. This abnormal behaviour compromises the well-being of the animals, can seriously impair animal health and can cause considerable economic losses. Tail biting has a multifactorial origin and occurs mainly in fattening pigs. High stocking densities, poor environment and bad air quality are seen as important factors. However, it is presumed that a plurality of internal and external motivators in intensive pig production can trigger this behaviour which is not reported in sounders of wild boars. The aim of this review is to summarize the causes and the effects of tail biting in pigs and present management strategies that are likely to reduce its incidence. In particular, management strategies by applying Precision Livestock Farming (PLF) technologies to monitor and control the behaviour of the pigs may be suitable to detect the outbreaks of tail biting at an early stage so that counter measures can be taken in time. PMID:23540192

  8. Application of strategies for sanitation management in wastewater treatment plants in order to control/reduce greenhouse gas emissions.

    PubMed

    Préndez, Margarita; Lara-González, Scarlette

    2008-09-01

    Greenhouse gases (GHG), basically methane (CH(4)), carbon dioxide (CO(2)) and nitrous oxide (N(2)O), occur at atmospheric concentrations of ppbv to ppmv under natural conditions. GHG have long mean lifetimes and are an important factor for the mean temperature of the Earth. However, increasing anthropogenic emissions could produce a scenario of progressive and cumulative effects over time, causing a potential "global climate change". Biological degradation of the organic matter present in wastewater is considered one of the anthropogenic sources of GHG. In this study, GHG emissions for the period 1990-2027 were estimated considering the sanitation process and the official domestic wastewater treatment startup schedule approved for the Metropolitan Region (MR) of Santiago, Chile. The methodology considers selected models proposed by the Intergovernmental Panel on Climate Change (IPCC) and some others published by different authors; these were modified according to national conditions and different sanitation and temporal scenarios. For the end of the modeled period (2027), results show emissions of about 65 Tg CO(2) equiv./year (as global warming potential), which represent around 50% of national emissions. These values could be reduced if certain sanitation management strategies were introduced in the environmental management by the sanitation company in charge of wastewater treatment. PMID:17548144

  9. Challenges in the Management of Patients with Chronic Obstructive Pulmonary Disease and Heart Failure With Reduced Ejection Fraction.

    PubMed

    Jaiswal, Abhishek; Chichra, Astha; Nguyen, Vinh Q; Gadiraju, Taraka V; Le Jemtel, Thierry H

    2016-02-01

    Chronic obstructive pulmonary disease (COPD) and heart failure with reduced ejection fraction (HFrEF) commonly coexist in clinical practice. The prevalence of COPD among HFrEF patients ranges from 20 to 32 %. On the other hand; HFrEF is prevalent in more than 20 % of COPD patients. With an aging population, the number of patients with coexisting COPD and HFrEF is on rise. Coexisting COPD and HFrEF presents a unique diagnostic and therapeutic clinical conundrum. Common symptoms shared by both conditions mask the early referral and detection of the other. Beta blockers (BB), angiotensin-converting enzyme inhibitors, and aldosterone antagonists have been shown to reduce hospitalizations, morbidity, and mortality in HFrEF while long-acting inhaled bronchodilators (beta-2-agonists and anticholinergics) and corticosteroids have been endorsed for COPD treatment. The opposing pharmacotherapy of BBs and beta-2-agonists highlight the conflict in prescribing BBs in COPD and beta-2-agonists in HFrEF. This has resulted in underutilization of evidence-based therapy for HFrEF in COPD patients owing to fear of adverse effects. This review aims to provide an update and current perspective on diagnostic and therapeutic management of patients with coexisting COPD and HFrEF. PMID:26780914

  10. Shift work: health, performance and safety problems, traditional countermeasures, and innovative management strategies to reduce circadian misalignment

    PubMed Central

    Smith, Mark R; Eastman, Charmane I

    2012-01-01

    There are three mechanisms that may contribute to the health, performance, and safety problems associated with night-shift work: (1) circadian misalignment between the internal circadian clock and activities such as work, sleep, and eating, (2) chronic, partial sleep deprivation, and (3) melatonin suppression by light at night. The typical countermeasures, such as caffeine, naps, and melatonin (for its sleep-promoting effect), along with education about sleep and circadian rhythms, are the components of most fatigue risk-management plans. We contend that these, while better than nothing, are not enough because they do not address the underlying cause of the problems, which is circadian misalignment. We explain how to reset (phase-shift) the circadian clock to partially align with the night-work, day-sleep schedule, and thus reduce circadian misalignment while preserving sleep and functioning on days off. This involves controlling light and dark using outdoor light exposure, sunglasses, sleep in the dark, and a little bright light during night work. We present a diagram of a sleep-and-light schedule to reduce circadian misalignment in permanent night work, or a rotation between evenings and nights, and give practical advice on how to implement this type of plan. PMID:23620685

  11. Can mass trapping reduce thrips damage and is it economically viable? Management of the Western flower thrips in strawberry.

    PubMed

    Sampson, Clare; Kirk, William D J

    2013-01-01

    The western flower thrips Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae) is a cosmopolitan, polyphagous insect pest that causes bronzing to fruit of strawberry (Fragaria x ananassa). The main aim of this study was to test whether mass trapping could reduce damage and to predict whether this approach would be economically viable. In semi-protected strawberry crops, mass trapping of F. occidentalis using blue sticky roller traps reduced adult thrips numbers per flower by 61% and fruit bronzing by 55%. The addition of the F. occidentalis aggregation pheromone, neryl (S)-2-methylbutanoate, to the traps doubled the trap catch, reduced adult thrips numbers per flower by 73% and fruit bronzing by 68%. The factors affecting trapping efficiency through the season are discussed. Damage that would result in downgrading of fruit to a cheaper price occurred when bronzing affected about 10% of the red fruit surface. Cost-benefit analysis using this threshold showed that mass trapping of thrips using blue sticky roller traps can be cost-effective in high-value crops. The addition of blue sticky roller traps to an integrated pest management programme maintained thrips numbers below the damage threshold and increased grower returns by a conservative estimate of £2.2k per hectare. Further work is required to develop the F. occidentalis aggregation pheromone for mass trapping and to determine the best timing for trap deployment. Mass trapping of thrips is likely to be cost-effective in other countries and other high-value crops affected by F. occidentalis damage, such as cucumber and cut flowers. PMID:24282554

  12. Cool Temperatures Reduce Antifungal Activity of Symbiotic Bacteria of Threatened Amphibians – Implications for Disease Management and Patterns of Decline

    PubMed Central

    Daskin, Joshua H.; Bell, Sara C.; Schwarzkopf, Lin; Alford, Ross A.

    2014-01-01

    Chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), is a widespread disease of amphibians responsible for population declines and extinctions. Some bacteria from amphibians’ skins produce antimicrobial substances active against Bd. Supplementing populations of these cutaneous antifungal bacteria might help manage chytridiomycosis in wild amphibians. However, the activity of protective bacteria may depend upon environmental conditions. Biocontrol of Bd in nature thus requires knowledge of how environmental conditions affect their anti-Bd activity. For example, Bd-driven amphibian declines have often occurred at temperatures below Bd’s optimum range. It is possible these declines occurred due to reduced anti-Bd activity of bacterial symbionts at cool temperatures. Better understanding of the effects of temperature on chytridiomycosis development could also improve risk evaluation for amphibian populations yet to encounter Bd. We characterized, at a range of temperatures approximating natural seasonal variation, the anti-Bd activity of bacterial symbionts from the skins of three species of rainforest tree frogs (Litoria nannotis, Litoria rheocola, and Litoria serrata). All three species declined during chytridiomycosis outbreaks in the late 1980s and early 1990s and have subsequently recovered to differing extents. We collected anti-Bd bacterial symbionts from frogs and cultured the bacteria at constant temperatures from 8°C to 33°C. Using a spectrophotometric assay, we monitored Bd growth in cell-free supernatants (CFSs) from each temperature treatment. CFSs from 11 of 24 bacteria showed reduced anti-Bd activity in vitro when they were produced at cool temperatures similar to those encountered by the host species during population declines. Reduced anti-Bd activity of metabolites produced at low temperatures may, therefore, partially explain the association between Bd-driven declines and cool temperatures. We show that to avoid

  13. Modeling of solar radiation management: a comparison of simulations using reduced solar constant and stratospheric sulphate aerosols

    NASA Astrophysics Data System (ADS)

    Kalidindi, Sirisha; Bala, Govindasamy; Modak, Angshuman; Caldeira, Ken

    2015-05-01

    The climatic effects of Solar Radiation Management (SRM) geoengineering have been often modeled by simply reducing the solar constant. This is most likely valid only for space sunshades and not for atmosphere and surface based SRM methods. In this study, a global climate model is used to evaluate the differences in the climate response to SRM by uniform solar constant reduction and stratospheric aerosols. Our analysis shows that when global mean warming from a doubling of CO2 is nearly cancelled by both these methods, they are similar when important surface and tropospheric climate variables are considered. However, a difference of 1 K in the global mean stratospheric (61-9.8 hPa) temperature is simulated between the two SRM methods. Further, while the global mean surface diffuse radiation increases by ~23 % and direct radiation decreases by about 9 % in the case of sulphate aerosol SRM method, both direct and diffuse radiation decrease by similar fractional amounts (~1.0 %) when solar constant is reduced. When CO2 fertilization effects from elevated CO2 concentration levels are removed, the contribution from shaded leaves to gross primary productivity (GPP) increases by 1.8 % in aerosol SRM because of increased diffuse light. However, this increase is almost offset by a 15.2 % decline in sunlit contribution due to reduced direct light. Overall both the SRM simulations show similar decrease in GPP (~8 %) and net primary productivity (~3 %). Based on our results we conclude that the climate states produced by a reduction in solar constant and addition of aerosols into the stratosphere can be considered almost similar except for two important aspects: stratospheric temperature change and the consequent implications for the dynamics and the chemistry of the stratosphere and the partitioning of direct versus diffuse radiation reaching the surface. Further, the likely dependence of global hydrological cycle response on aerosol particle size and the latitudinal and

  14. Can Mass Trapping Reduce Thrips Damage and Is It Economically Viable? Management of the Western Flower Thrips in Strawberry

    PubMed Central

    Sampson, Clare; Kirk, William D. J.

    2013-01-01

    The western flower thrips Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae) is a cosmopolitan, polyphagous insect pest that causes bronzing to fruit of strawberry (Fragaria x ananassa). The main aim of this study was to test whether mass trapping could reduce damage and to predict whether this approach would be economically viable. In semi-protected strawberry crops, mass trapping of F. occidentalis using blue sticky roller traps reduced adult thrips numbers per flower by 61% and fruit bronzing by 55%. The addition of the F. occidentalis aggregation pheromone, neryl (S)-2-methylbutanoate, to the traps doubled the trap catch, reduced adult thrips numbers per flower by 73% and fruit bronzing by 68%. The factors affecting trapping efficiency through the season are discussed. Damage that would result in downgrading of fruit to a cheaper price occurred when bronzing affected about 10% of the red fruit surface. Cost-benefit analysis using this threshold showed that mass trapping of thrips using blue sticky roller traps can be cost-effective in high-value crops. The addition of blue sticky roller traps to an integrated pest management programme maintained thrips numbers below the damage threshold and increased grower returns by a conservative estimate of £2.2k per hectare. Further work is required to develop the F. occidentalis aggregation pheromone for mass trapping and to determine the best timing for trap deployment. Mass trapping of thrips is likely to be cost-effective in other countries and other high-value crops affected by F. occidentalis damage, such as cucumber and cut flowers. PMID:24282554

  15. Cool temperatures reduce antifungal activity of symbiotic bacteria of threatened amphibians--implications for disease management and patterns of decline.

    PubMed

    Daskin, Joshua H; Bell, Sara C; Schwarzkopf, Lin; Alford, Ross A

    2014-01-01

    Chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd), is a widespread disease of amphibians responsible for population declines and extinctions. Some bacteria from amphibians' skins produce antimicrobial substances active against Bd. Supplementing populations of these cutaneous antifungal bacteria might help manage chytridiomycosis in wild amphibians. However, the activity of protective bacteria may depend upon environmental conditions. Biocontrol of Bd in nature thus requires knowledge of how environmental conditions affect their anti-Bd activity. For example, Bd-driven amphibian declines have often occurred at temperatures below Bd's optimum range. It is possible these declines occurred due to reduced anti-Bd activity of bacterial symbionts at cool temperatures. Better understanding of the effects of temperature on chytridiomycosis development could also improve risk evaluation for amphibian populations yet to encounter Bd. We characterized, at a range of temperatures approximating natural seasonal variation, the anti-Bd activity of bacterial symbionts from the skins of three species of rainforest tree frogs (Litoria nannotis, Litoria rheocola, and Litoria serrata). All three species declined during chytridiomycosis outbreaks in the late 1980s and early 1990s and have subsequently recovered to differing extents. We collected anti-Bd bacterial symbionts from frogs and cultured the bacteria at constant temperatures from 8 °C to 33 °C. Using a spectrophotometric assay, we monitored Bd growth in cell-free supernatants (CFSs) from each temperature treatment. CFSs from 11 of 24 bacteria showed reduced anti-Bd activity in vitro when they were produced at cool temperatures similar to those encountered by the host species during population declines. Reduced anti-Bd activity of metabolites produced at low temperatures may, therefore, partially explain the association between Bd-driven declines and cool temperatures. We show that to avoid

  16. Determining which land management practices reduce catchment scale flood risk and where to implement them for optimum effect

    NASA Astrophysics Data System (ADS)

    Pattison, Ian; Lane, Stuart; Hardy, Richard; Reaney, Sim

    2010-05-01

    The theoretical basis for why changes in land management might increase flood risk are well known, but proving them through numerical modelling still remains a challenge. In large catchments, like the River Eden in Cumbria, NW England, one of the reasons for this is that it is unfeasible to test multiple scenarios in all their possible locations. We have developed two linked approaches to refine the number of scenarios and locations using 1) spatial downscaling and 2) participatory decision making, which potentially should increase the likelihood of finding a link between land use and downstream flooding. Firstly, land management practices can have both flood reducing and flood increasing effects, depending on their location. As a result some areas of the catchment are more important in determining downstream flood risk than others, depending on the land use and hydrological connectivity. We apply a downscaling approach to identify which sub-catchments are most important in explaining downstream flooding. This is important because it is in these areas that management options are most likely to have a positive and detectable effect. Secondly, once the dominant sub-catchment has been identified, the land management scenarios that are both feasible and likely to impact flood risk need to be determined. This was done through active stakeholder engagement. The stakeholder group undertook a brainstorming exercise, which suggested about 30 different rural land management scenarios, which were mapped on to a literature-based conceptual framework of hydrological processes. Then these options were evaluated based on five criteria: relevance to catchment, scientific effectiveness, testability, robustness/uncertainty and feasibility of implementation. The suitability of each scenario was discussed and prioritised by the stakeholder group based on scientific needs and expectations and local suitability and feasibility. The next stage of the participatory approach was a mapping

  17. Group Training of Stress Management vs. Group Cognitive-Behavioral Therapy in Reducing Depression, Anxiety and Perceived Stress Among HIV-Positive Men

    PubMed Central

    Hemmati Sabet, Akbar; Khalatbari, Javad; Abbas Ghorbani, Maryam; Haghighi, Mohammad; Ahmadpanah, Mohammad

    2013-01-01

    Objective: To compare the effectiveness of group training of stress management with cognitive-behavioral therapy (CBT) in reducing depression, anxiety and stress perceived among HIV-positive men. Methods:Inthis semi-experimental study, three groups of HIV-positive men (CBT group, stress management group, and control group) including 15 patients in each group were compared regarding depression, anxiety, and stress using pre-test and post-test tools. Results: Both interventions (CBT and stress management) were effective in reducing depression, anxiety and perceived stress. Evaluating adjustedmean showed the more effectivenessofthe group stressmanagementtraining than CBT. Conclusion: Group stress management training is more effective than group CBT in HIV-positive mentodecreasedepression, anxiety and stress management. Declaration of interest: None. Clinical Trial Registration: URL: http://.irct.ir. Unique identifier: 2012121711782N1 PMID:24644493

  18. Reducing the predictive uncertainty associated with groundwater management decision-making in the Perth regional aquifer system of Western Australia

    NASA Astrophysics Data System (ADS)

    Siade, A. J.

    2015-12-01

    The Perth Regional Aquifer Model (PRAMS) framework has been used for about a decade now to evaluate the potential anthropogenic impacts associated with management decisions that affect Perth's groundwater resources. A great wealth of data, expertise and numerical analysis have gone into the development of PRAMS over the years. However, there has been little quantitative work conducted on systemically addressing the uncertainty in the model's structure and predictions. PRAMS is designed to make a variety of regional and local-scale predictions and, both the nature and magnitude of the uncertainty associated with these predictions can vary significantly. A primary prediction to be addressed using the PRAMS framework, will be the effects of various deep-aquifer groundwater management scenarios on both the environmental and social concerns surrounding the superficial aquifer, which supports sensitive wetlands, and the negative impacts of seawater intrusion into the deep aquifers. A particular model-structure component that greatly affects the predictions associated with deep-aquifer groundwater extraction is the characterization of the local fault structure, i.e., whether or not faults are acting as barriers to groundwater flow. Therefore, uncertainty in fault characterization can subsequently lead to significant predictive uncertainty. However, new observation data can be obtained to reduce this uncertainty. In this study, an experimental design methodology is employed to optimally acquire new observations of state in such a way as to maximize the information obtained about the hydraulic properties of faults. Various information criteria are employed to develop optimal locations of new observation wells. The A-optimality criterion was found to be the most effective for comparing sampling strategies given the design assumptions, which include the parameter sets employed, hydraulic forcing, temporal considerations, and the use of the existing observation network. A

  19. Estimation and evaluation of management options to control and/or reduce the risk of not complying with commercial sterility.

    PubMed

    Pujol, Laure; Albert, Isabelle; Magras, Catherine; Johnson, Nicholas Brian; Membré, Jeanne-Marie

    2015-11-20

    In a previous study, a modular process risk model, from the raw material reception to the final product storage, was built to estimate the risk of a UHT-aseptic line of not complying with commercial sterility (Pujol et al., 2015). This present study was focused on demonstrating how the model (updated version with uncertainty and variability separated and 2(nd) order Monte Carlo procedure run) could be used to assess quantitatively the influence of management options. This assessment was done in three steps: pinpoint which process step had the highest influence on the risk, identify which management option(s) could be the most effective to control and/or reduce the risk, and finally evaluate quantitatively the influence of changing process setting(s) on the risk. For Bacillus cereus, it was identified that during post-process storage in an aseptic tank, there was potentially an air re-contamination due to filter efficiency loss (efficiency loss due to successive in-place sterilizations after cleaning operations), followed by B. cereus growth. Two options were then evaluated: i) reducing by one fifth of the number of filter sterilizations before renewing the filters, ii) designing new UHT-aseptic lines without an aseptic tank, i.e. without a storage period after the thermal process and before filling. Considering the uncertainty in the model, it was not possible to confirm whether these options had a significant influence on the risk associated with B. cereus. On the other hand, for Geobacillus stearothermophilus, combinations of heat-treatment time and temperature enabling the control or reduction in risk by a factor of ca. 100 were determined; for ease of operational implementation, they were presented graphically in the form of iso-risk curves. For instance, it was established that a heat treatment of 138°C for 31s (instead of 138°C for 25s) enabled a reduction in risk to 18×10(-8) (95% CI=[10; 34]×10(-8)), instead of 578×10(-8) (95% CI=[429; 754]×10

  20. A managed protocol for treatment of deceased potential donors reduces the incidence of cardiac arrest before organ explant

    PubMed Central

    Westphal, Glauco Adrieno; Zaclikevis, Viviane Renata; Vieira, Kalinca Daberkow; Cordeiro, Rodrigo de Brito; Horner, Marina Borges W.; de Oliveira, Thamy Pellizzaro; Duarte, Robson; Sperotto, Geonice; da Silveira, Georgiana; Caldeira, Milton; Coll, Elisabeth; Yus-Teruel, Santiago

    2012-01-01

    Objective To assess the effect of the application of a managed protocol for the maintenance care of deceased potential multiple organ donors at two hospitals. Methods A before (Phase 1)/after (Phase 2) study conducted at two general hospitals, which included consecutively potential donors admitted to two intensive care units. In Phase 1 (16 months), the data were collected retrospectively, and the maintenance care measures of the potential donors were instituted by the intensivists. In Phase 2 (12 months), the data collection was prospective, and a managed protocol was used for maintenance care. The two phases were compared in terms of their demographic variables, physiological variables at diagnosis of brain death and the end of the process, time to performance of brain death confirmatory test and end of the process, adherence to bundles of maintenance care essential measures, losses due to cardiac arrest, family refusal, contraindications, and the conversion rate of potential into actual donors. Student's t- and chi-square tests were used, and p-value < 0.05 was considered to be significant. Results A total of 42 potential donors were identified (18 in Phase 1 and 24 in Phase 2). The time interval between the first clinical assessment and the recovery decreased in Phase 2 (Phase 1: 35.0±15.5 hours versus Phase 2: 24.6±6.2 hours; p = 0.023). Adherence increased to 10 out of the 19 essential items of maintenance care, and losses due to cardiac arrest also decreased in Phase 2 (Phase 1: 27.8 versus 0% in Phase 2; p = 0.006), while the convertion rate increased (Phase 1: 44.4 versus 75% in Phase 2; p = 0.044). The losses due to family refusal and medical contraindication did not vary. Conclusion The adoption of a managed protocol focused on the application of essential measures for the care of potential deceased donors might reduce the loss of potential donors due to cardiac arrest. PMID:23917929

  1. Cost-effectiveness of reducing glycaemic episodes through community pharmacy management of patients with type 2 diabetes mellitus.

    PubMed

    Hendrie, Delia; Miller, Ted R; Woodman, Richard J; Hoti, Kreshnik; Hughes, Jeff

    2014-12-01

    Accessibility, availability and frequent public contact place community pharmacists in an ideal position to provide medically necessary, intensive health education and preventive health services to diabetes patients, thus reducing physician burden. We assessed the cost-effectiveness of reducing glycaemic episodes in patients with type 2 diabetes mellitus through a pharmacist-led Diabetes Management Education Program (DMEP) compared to standard care. We recruited eight metropolitan community pharmacies in Perth, Western Australia for the study. We paired them based on geographical location and the socioeconomic status of the population served, and then randomly selected one pharmacy in each pair to be in the intervention group, with the other assigned to the control group. We conducted an incremental cost-effectiveness analysis to compare the costs and effectiveness of DMEP with standard pharmacy care. Cost per patient of implementing DMEP was AU$394 (US$356) for the 6-month intervention period. Significantly greater reductions in number of hyperglycaemic and hypoglycaemic episodes occurred in the intervention relative to the control group [OR 0.34 (95 % CI 0.22, 0.52), p = 0.001; OR 0.54 (95 % CI 0.34, 0.86), p = 0.009], respectively, with a net reduction of 1.86 days with glycaemic episodes per patient per month. The cost-effectiveness of DMEP relative to standard pharmacy care was AU$43 (US$39) per day of glycaemic symptoms avoided. Patients with type 2 diabetes in three surveys were willing to pay an average of 1.9 times that amount to avoid a hypoglycaemic day. We conclude that DMEP decreased days with glycaemic symptoms at a reasonable cost. If a larger-scale replication study confirms these findings, widespread adoption of this approach would improve diabetes health without burdening general practitioners. PMID:25257687

  2. Short communication: Evaluation of milk urea nitrogen as a management tool to reduce ammonia emissions from dairy farms.

    PubMed

    Powell, J M; Wattiaux, M A; Broderick, G A

    2011-09-01

    The purpose of this study was to compile and evaluate relationships between feed nitrogen (N) intake, milk urea N (MUN), urinary urea N (UUN), and ammonia (NH(3)) emissions from dairy farms to aid policy development. Regression relationships between MUN, UUN, and NH(3) emissions were compiled from studies conducted in Wisconsin, California, and the Netherlands. Relative reductions in NH(3) emissions were calculated as percentage decreases in NH(3) emissions associated with a baseline MUN level of 14 mg/dL (prevailing industry average). For 3 studies with cows in stanchion barns, relative NH(3) emission reductions of 10.3 to 28.2% were obtained when MUN declined from 14 to 10mg/dL. Similarly, analyses of 2 freestall studies provided relative NH(3) emission reductions of 10.5 to 33.7% when MUN levels declined from 14 to 10mg/dL. The relative reductions in NH(3) emissions from both stanchion and freestall barns can be associated directly with reductions in UUN excretion, which can be determined using MUN. The results of this study may help create new awareness, and perhaps eventual industry-based incentives, for management practices that enhance feed N use efficiency and reduce MUN, UUN, and NH(3) emissions from dairy farms. PMID:21854942

  3. Design of Experiments with Multiple Independent Variables: A Resource Management Perspective on Complete and Reduced Factorial Designs

    PubMed Central

    Collins, Linda M.; Dziak, John J.; Li, Runze

    2009-01-01

    An investigator who plans to conduct experiments with multiple independent variables must decide whether to use a complete or reduced factorial design. This article advocates a resource management perspective on making this decision, in which the investigator seeks a strategic balance between service to scientific objectives and economy. Considerations in making design decisions include whether research questions are framed as main effects or simple effects; whether and which effects are aliased (confounded) in a particular design; the number of experimental conditions that must be implemented in a particular design and the number of experimental subjects the design requires to maintain the desired level of statistical power; and the costs associated with implementing experimental conditions and obtaining experimental subjects. In this article four design options are compared: complete factorial, individual experiments, single factor, and fractional factorial designs. Complete and fractional factorial designs and single factor designs are generally more economical than conducting individual experiments on each factor. Although relatively unfamiliar to behavioral scientists, fractional factorial designs merit serious consideration because of their economy and versatility. PMID:19719358

  4. Application of Sleeper Cab Thermal Management Technologies to Reduce Idle Climate Control Loads in Long-Haul Trucks

    SciTech Connect

    Lustbader, J. A.; Venson, T.; Adelman, S.; Dehart, C.; Yeakel, S.; Castillo, M. S.

    2012-10-01

    Each intercity long-haul truck in the U.S. idles approximately 1,800 hrs per year, primarily for sleeper cab hotel loads. Including workday idling, over 2 billion gallons of fuel are used annually for truck idling. NREL's CoolCab project works closely with industry to design efficient thermal management systems for long-haul trucks that keep the cab comfortable with minimized engine idling and fuel use. The impact of thermal load reduction technologies on idle reduction systems were characterized by conducting thermal soak tests, overall heat transfer tests, and 10-hour rest period A/C tests. Technologies evaluated include advanced insulation packages, a solar reflective film applied to the vehicle's opaque exterior surfaces, a truck featuring both film and insulation, and a battery-powered A/C system. Opportunities were identified to reduce heating and cooling loads for long-haul truck idling by 36% and 34%, respectively, which yielded a 23% reduction in battery pack capacity of the idle-reduction system. Data were also collected for development and validation of a CoolCalc HVAC truck cab model. CoolCalc is an easy-to-use, simplified, physics-based HVAC load estimation tool that requires no meshing, has flexible geometry, excludes unnecessary detail, and is less time-intensive than more detailed computer-aided engineering modeling approaches.

  5. Introduction to Special Edition (of the Journal of Nuclear Materials Management) on Reducing the Threat from Radioactive Materials

    SciTech Connect

    Mladineo, Stephen V.

    2007-03-01

    Introductory article for special edition of the JOURNAL OF NUCLEAR MATERIALS MANAGEMENT outlining the Institute of Nuclear Materials Management Nonproliferation and Arms Control Technical Division. In particular the International Nuclear and Radiological Security Standing Committee and its initial focus covering four topical areas--Radiological Threat Reduction, Nuclear Smuggling and Illicit Trafficking, Countering Nuclear Terrorism, and Radioligical Terrorism Consequence Management.

  6. Modeling of Solar Radiation Management: A Comparison of Simulations Using Reduced Solar Constant and Stratospheric Sulphate Aerosols

    NASA Astrophysics Data System (ADS)

    Bala, G.; Kalidindi, S.; Modak, A.; Caldeira, K.

    2014-12-01

    Several climate modelling studies in the past have used reduction in solar constant to simulate the climatic effects of Solar Radiation Management (SRM) geoengineering. This is most likely valid only for space-based mirrors/reflectors but not for SRM methods that rely on stratospheric aerosols. In this study, we use a climate model to evaluate the differences in climate response to SRM by uniform solar constant reduction and stratospheric aerosols. The experiments are designed such that global mean warming from a doubling of atmospheric CO2 concentration (2xCO2) is nearly cancelled in each case. In such a scenario, the residual climate effects are similar when important surface and tropospheric climate variables such as temperature and precipitation are considered. However, there are significant differences in stratospheric temperature response and diffuse and direct radiation reaching the surface. A difference of 1K in the global mean stratospheric (61-9.8 hPa) temperature is simulated between the two SRM methods, with warming in the aerosol scheme and a slight cooling for sunshades. While the global mean surface diffuse radiation increases by ~23% and direct radiation decreases by about 9% in the case of aerosol SRM method, both direct and diffuse radiation decrease by similar fractional amounts (~1.0%) when solar constant is reduced. When CO2 fertilization effects from elevated CO2 concentration levels are removed, the contribution from shaded leaves to gross primary productivity (GPP) increases by 1.8 % in aerosol SRM because of increased diffuse light. However, this increase is almost offset by a 15.2% decline in sunlit contribution due to reduced direct light. Overall both the SRM simulations show similar decrease in GPP (~ 8%) and NPP (~3%) relative to 2xCO2, indicating the negligible effect of the fractional changes in direct/diffuse radiation on the overall plant productivity. Based on our modelling study, we conclude that the climate states produced by a

  7. Managing Eastern tent caterpillars Malacosoma americanum (F) on horse farms to reduce risk of mare reproductive loss syndrome.

    PubMed

    Potter, Daniel A; Foss, Leslie; Baumler, Rebecca E; Held, David W

    2005-01-01

    An equine disease now known as mare reproductive loss syndrome (MRLS) struck the Ohio Valley in 2001-2002 causing thousands of foal abortions and enormous economic loss. Evidence that pregnant mares' exposure to Eastern tent caterpillars Malacosoma americanum (F) induces MRLS created an urgent call for control measures suitable for use on horse farms. We surveyed egg mass distribution and monitored emergence in wild cherry trees, and evaluated reduced-risk treatment strategies including foliage sprays, trunk injections, winter egg mass treatments and barrier sprays to intercept larvae entering pastures. Egg masses were concentrated in the lower canopy, on exposed sides of trees. Larval emergence began in mid-March. Emergence was prolonged (3-4 weeks) in 2002, a typically cool spring, but more synchronized in warmer 2003. Winter treatment of egg masses with bifenthrin or permethrin in a penetrating solvent prevented emergence, but 3% horticultural oil was ineffective for that purpose. Insecticidal soap or oil sprayed directly on neonates gave relatively poor control. Bifenthrin and spinosad were effective as foliage sprays against all instars, their field-weathered residues active for at least 7 days. Bacillus thuringiensis Berliner var kurstaki controlled neonates within 3 days but was less active against late instars, with shorter residual action than bifenthrin or spinosad. Larvae did not avoid insecticide-treated leaves. Trunk microinjection of cherry trees with dicrotophos was effective against all instars, whereas microinjection with milbemectin or abamectin gave poor or inconsistent control. Trunk injection with emamectin benzoate also was effective. Dry permethrin residues controlled late instars crawling in pasture grass for at least 7 days. Factors complicating M americanum management on horse farms are discussed. PMID:15593079

  8. Combined effects of constant versus variable intensity simulated rainfall and reduced tillage management on cotton preemergence herbicide runoff.

    PubMed

    Potter, Thomas L; Truman, Clint C; Strickland, Timothy C; Bosch, David D; Webster, Theodore M; Franklin, Dorcas H; Bednarz, Craig W

    2006-01-01

    Pesticide runoff research relies heavily on rainfall simulation experiments. Most are conducted at a constant intensity, i.e., at a fixed rainfall rate; however, large differences in natural rainfall intensity is common. To assess implications we quantified runoff of two herbicides, fluometuron and pendimethalin, and applied preemergence after planting cotton on Tifton loamy sand. Rainfall at constant and variable intensity patterns representative of late spring thunderstorms in the Atlantic Coastal Plain region of Georgia (USA) were simulated on 6-m2 plots under strip- (ST) and conventional-tillage (CT) management. The variable pattern produced significantly higher runoff rates of both compounds from CT but not ST plots. However, on an event-basis, runoff totals (% applied) were not significantly different, with one exception: fluometuron runoff from CT plots. There was about 25% more fluometuron runoff with the variable versus the constant intensity pattern (P = 0.10). Study results suggest that conduct of simulations using variable intensity storm patterns may provide more representative rainfall simulation-based estimates of pesticide runoff and that the greatest impacts will be observed with CT. The study also found significantly more fluometuron in runoff from ST than CT plots. Further work is needed to determine whether this behavior may be generalized to other active ingredients with similar properties [low K(oc) (organic carbon partition coefficient) approximately 100 mL g(-1); high water solubility approximately 100 mg L(-1)]. If so, it should be considered when making tillage-specific herbicide recommendations to reduce runoff potential. PMID:16973631

  9. Managing runoff and flow pathways in a small rural catchment to reduce flood risk with other multi-purpose benefits

    NASA Astrophysics Data System (ADS)

    Wilkinson, Mark; Welton, Phil; Kerr, Peter; Quinn, Paul; Jonczyk, Jennine

    2010-05-01

    From 2000 to 2009 there have been a high number of flood events throughout Northern Europe. Meanwhile, there is a demand for land in which to construct homes and businesses on, which is encroaching on land which is prone to flooding. Nevertheless, flood defences usually protect us from this hazard. However, the severity of floods and this demand for land has increased the number of homes which have been flooded in the past ten years. Public spending on flood defences can only go so far which targets the large populations first. Small villages and communities, where in many cases normal flood defences are not cost effective, tend to wait longer for flood mitigation strategies. The Belford Burn (Northumberland, UK) catchment is a small rural catchment that drains an area of 6 km2. It flows through the village of Belford. There is a history of flooding in Belford, with records of flood events dating back to 1877. Normal flood defences are not suitable for this catchment as it failed the Environment Agency (EA) cost benefit criteria for support. There was a desire by the local EA Flood Levy Team and the Northumbria Regional Flood Defence Committee at the Environment Agency to deliver an alternative catchment-based solution to the problem. The EA North East Flood Levy team and Newcastle University have created a partnership to address the flood problem using soft engineered runoff management features. Farm Integrated Runoff Management (FIRM) plans manage flow paths directly by storing slowing and filtering runoff at source on farms. The features are multipurpose addressing water quality, trapping sediment, creating new habitats and storing and attenuating flood flow. Background rainfall and stream stage data have been collected since November 2007. Work on the first mitigation features commenced in July 2008. Since that date five flood events have occurred in the catchment. Two of these flood events caused widespread damage in other areas of the county. However, in

  10. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASA's Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Johnson, Stephen B.; Patterson, Jonathan; Teare, David

    2015-01-01

    The development of the Space Launch System (SLS) launch vehicle requires cross discipline teams with extensive knowledge of launch vehicle subsystems, information theory, and autonomous algorithms dealing with all operations from pre-launch through on orbit operations. The characteristics of these systems must be matched with the autonomous algorithm monitoring and mitigation capabilities for accurate control and response to abnormal conditions throughout all vehicle mission flight phases, including precipitating safing actions and crew aborts. This presents a large complex systems engineering challenge being addressed in part by focusing on the specific subsystems handling of off-nominal mission and fault tolerance. Using traditional model based system and software engineering design principles from the Unified Modeling Language (UML), the Mission and Fault Management (M&FM) algorithms are crafted and vetted in specialized Integrated Development Teams composed of multiple development disciplines. NASA also has formed an M&FM team for addressing fault management early in the development lifecycle. This team has developed a dedicated Vehicle Management End-to-End Testbed (VMET) that integrates specific M&FM algorithms, specialized nominal and off-nominal test cases, and vendor-supplied physics-based launch vehicle subsystem models. The flexibility of VMET enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the algorithms utilizing actual subsystem models. The intent is to validate the algorithms and substantiate them with performance baselines for each of the vehicle subsystems in an independent platform exterior to flight software test processes. In any software development process there is inherent risk in the interpretation and implementation of concepts into software through requirements and test processes. Risk reduction is addressed by working with other organizations such as S

  11. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASAs Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Johnson, Stephen B.; Patterson, Jonathan; Teare, David

    2015-01-01

    ) early in the development lifecycle for the SLS program, NASA formed the M&FM team as part of the Integrated Systems Health Management and Automation Branch under the Spacecraft Vehicle Systems Department at the Marshall Space Flight Center (MSFC). To support the development of the FM algorithms, the VMET developed by the M&FM team provides the ability to integrate the algorithms, perform test cases, and integrate vendor-supplied physics-based launch vehicle (LV) subsystem models. Additionally, the team has developed processes for implementing and validating the M&FM algorithms for concept validation and risk reduction. The flexibility of the VMET capabilities enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the developed algorithms utilizing actual subsystem models such as MPS, GNC, and others. One of the principal functions of VMET is to validate the M&FM algorithms and substantiate them with performance baselines for each of the target vehicle subsystems in an independent platform exterior to the flight software test and validation processes. In any software development process there is inherent risk in the interpretation and implementation of concepts from requirements and test cases into flight software compounded with potential human errors throughout the development and regression testing lifecycle. Risk reduction is addressed by the M&FM group but in particular by the Analysis Team working with other organizations such as S&MA, Structures and Environments, GNC, Orion, Crew Office, Flight Operations, and Ground Operations by assessing performance of the M&FM algorithms in terms of their ability to reduce Loss of Mission (LOM) and Loss of Crew (LOC) probabilities. In addition, through state machine and diagnostic modeling, analysis efforts investigate a broader suite of failure effects and associated detection and responses to be tested in VMET to ensure reliable failure

  12. Modelling Coral Reef Futures to Inform Management: Can Reducing Local-Scale Stressors Conserve Reefs under Climate Change?

    PubMed Central

    Gurney, Georgina G.; Melbourne-Thomas, Jessica; Geronimo, Rollan C.; Aliño, Perry M.; Johnson, Craig R.

    2013-01-01

    Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef

  13. Modelling coral reef futures to inform management: can reducing local-scale stressors conserve reefs under climate change?

    PubMed

    Gurney, Georgina G; Melbourne-Thomas, Jessica; Geronimo, Rollan C; Aliño, Perry M; Johnson, Craig R

    2013-01-01

    Climate change has emerged as a principal threat to coral reefs, and is expected to exacerbate coral reef degradation caused by more localised stressors. Management of local stressors is widely advocated to bolster coral reef resilience, but the extent to which management of local stressors might affect future trajectories of reef state remains unclear. This is in part because of limited understanding of the cumulative impact of multiple stressors. Models are ideal tools to aid understanding of future reef state under alternative management and climatic scenarios, but to date few have been sufficiently developed to be useful as decision support tools for local management of coral reefs subject to multiple stressors. We used a simulation model of coral reefs to investigate the extent to which the management of local stressors (namely poor water quality and fishing) might influence future reef state under varying climatic scenarios relating to coral bleaching. We parameterised the model for Bolinao, the Philippines, and explored how simulation modelling can be used to provide decision support for local management. We found that management of water quality, and to a lesser extent fishing, can have a significant impact on future reef state, including coral recovery following bleaching-induced mortality. The stressors we examined interacted antagonistically to affect reef state, highlighting the importance of considering the combined impact of multiple stressors rather than considering them individually. Further, by providing explicit guidance for management of Bolinao's reef system, such as which course of management action will most likely to be effective over what time scales and at which sites, we demonstrated the utility of simulation models for supporting management. Aside from providing explicit guidance for management of Bolinao's reef system, our study offers insights which could inform reef management more broadly, as well as general understanding of reef

  14. Managing phosphorus fertilizer to reduce algae, maintain water quality, and sustain yields in water-seeded rice

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In water-seeded rice systems blue-green algae (cyanobacteria) hinder early-season crop growth by dislodging rice seedlings and reducing light. Since algae are often phosphorus (P) limited, we investigated whether changing the timing of P fertilizer application could reduce algae without reducing cro...

  15. Reducing School Administration to a Technicality? Philosophical Reflections of Senior German School Administrators in the Context of New Public Management-Based Vocational School Reform

    ERIC Educational Resources Information Center

    Wittmann, Eveline

    2006-01-01

    Vocational schools in Germany are currently undergoing administrative reform. The main idea behind this reform, taken from the administrative paradigm of New Public Management, has been to grant schools extended autonomy but to make them more accountable for their results. Critics emphasize that such reform tends to reduce school administration to…

  16. Improved Battery Pack Thermal Management to Reduce Cost and Increase Energy Density: Cooperative Research and Development Final Report, CRADA Number CRD-12-499

    SciTech Connect

    Smith, K.

    2013-10-01

    Under this CRADA NREL will support Creare's project for the Department of Energy entitled 'Improved Battery Pack Thermal Management to Reduce Cost and Increase Energy Density' which involves the development of an air-flow based cooling product that increases energy density, safety, and reliability of hybrid electric vehicle battery packs.

  17. Woodland biodiversity management as a tool for reducing human exposure to Ixodes ricinus ticks: a preliminary study in an english woodland.

    PubMed

    Medlock, J M; Shuttleworth, H; Copley, V; Hansford, K M; Leach, S

    2012-12-01

    This paper presents preliminary findings towards developing a UK-specific approach to reducing public exposure to woodland questing Ixodes ricinus tick populations by harnessing existing biodiversity-enhancing woodland ride (i.e., linear non-wooded herbaceous habitat either side of track within woodland) management strategies. This preliminary study in an English woodland firstly assesses whether ecological and environmental factors determine presence and density of questing Ixodes ricinus along woodland rides. Secondly, it sets these findings in the context of woodland ride management guidelines in England in order to understand what impact ride management strategies might have on numbers of questing ticks and tick survival. Nymph and adult I. ricinus presence and abundance were modelled in relation to relevant microclimate and ecological parameter variables. Predictor variables for increased questing nymph abundance included ride orientation, mat depth, occurrence of bracken/bramble and animal tracks, ride/path width, and sward height. Ticks thrive in the ecotonal habitat of a woodland ride, therefore we urge woodland managers to consider the impact of their ride management on ticks and human exposure to ticks. Possible recommendations for mitigating questing I. ricinus in line with biodiversity management guidelines rides are discussed in this paper and include seasonal mowing regimes, management of mulch/mat, and bracken/bramble management through use of scalloped ride edges. PMID:23181853

  18. Reducing Students' Carbon Footprints Using Personal Carbon Footprint Management System Based on Environmental Behavioural Theory and Persuasive Technology

    ERIC Educational Resources Information Center

    Lin, Shyh-ming

    2016-01-01

    This study applied environmental behavioural theories to develop a personal carbon footprint management system and used persuasive technology to implement it. The system serves as an educational system to improve the determinants of students' low-carbon behaviours, to promote low-carbon concepts and to facilitate their carbon management. To assess…

  19. A Vehicle Management End-to-End Testing and Analysis Platform for Validation of Mission and Fault Management Algorithms to Reduce Risk for NASA's Space Launch System

    NASA Technical Reports Server (NTRS)

    Trevino, Luis; Patterson, Jonathan; Teare, David; Johnson, Stephen

    2015-01-01

    integrates specific M&FM algorithms, specialized nominal and off-nominal test cases, and vendor-supplied physics-based launch vehicle subsystem models. Additionally, the team has developed processes for implementing and validating these algorithms for concept validation and risk reduction for the SLS program. The flexibility of the Vehicle Management End-to-end Testbed (VMET) enables thorough testing of the M&FM algorithms by providing configurable suites of both nominal and off-nominal test cases to validate the developed algorithms utilizing actual subsystem models such as MPS. The intent of VMET is to validate the M&FM algorithms and substantiate them with performance baselines for each of the target vehicle subsystems in an independent platform exterior to the flight software development infrastructure and its related testing entities. In any software development process there is inherent risk in the interpretation and implementation of concepts into software through requirements and test cases into flight software compounded with potential human errors throughout the development lifecycle. Risk reduction is addressed by the M&FM analysis group working with other organizations such as S&MA, Structures and Environments, GNC, Orion, the Crew Office, Flight Operations, and Ground Operations by assessing performance of the M&FM algorithms in terms of their ability to reduce Loss of Mission and Loss of Crew probabilities. In addition, through state machine and diagnostic modeling, analysis efforts investigate a broader suite of failure effects and associated detection and responses that can be tested in VMET to ensure that failures can be detected, and confirm that responses do not create additional risks or cause undesired states through interactive dynamic effects with other algorithms and systems. VMET further contributes to risk reduction by prototyping and exercising the M&FM algorithms early in their implementation and without any inherent hindrances such as meeting FSW

  20. Reducing asthma disparities by addressing environmental inequities: a case study of regional asthma management and prevention's advocacy efforts.

    PubMed

    Lamb, Anne Kelsey; Ervice, Joel; Lorenzen, Kathryn; Prentice, Bob; White, Shannon

    2011-01-01

    Regional Asthma Management and Prevention describes its collaborative approach to address a social determinant of health--air quality--and the associated inequities that have led to asthma disparities impacting African American and Latino communities in the San Francisco Bay Area. The strategies, aimed at decreasing diesel pollution in disproportionately impacted communities, span the levels of the socioecological model, with an emphasis on policy outcomes. Regional Asthma Management and Prevention describes how this work fits within a larger comprehensive approach to address asthma disparities encompassing several components, ranging from clinical management to environmental protection. PMID:21160331

  1. Reducing the dimensionality of soil microinvertebrate community datasets using Indicator Species Analysis: Implications for ecosystem monitoring and soil management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil microinvertebrates are closely associated with soil decomposition and nutrient cycles and may be particularly responsive indicators for soil management practices. However, identification of appropriate bioindicator species for many systems has been severely limited by a lack of information on ...

  2. Comparative Effectiveness of Risk-Stratified Care Management in Reducing Readmissions in Medicaid Adults With Chronic Disease.

    PubMed

    Hewner, Sharon; Wu, Yow-Wu Bill; Castner, Jessica

    2016-01-01

    Hospitalized adult Medicaid recipients with chronic disease are at risk for rehospitalization within 90 days of discharge, but most research has focused on the Medicare population. The purpose of this study is to examine the impact of population-based care management intensity on inpatient readmissions in Medicaid adults with pre-existing chronic disease. Retrospective analyses of 2,868 index hospital admissions from 2012 New York State Medicaid Data Warehouse claims compared 90-day post-discharge utilization in populations with and without transitional care management interventions. High intensity managed care organization interventions were associated with higher outpatient and lower emergency department post-discharge utilization than low intensity fee-for-service management. However, readmission rates were higher for the managed care cases. Shorter time to readmission was associated with managed care, diagnoses that include heart and kidney failure, shorter length of stay for index hospitalization, and male sex; with no relationship to age. This unexpected result flags the need to re-evaluate readmission as a quality indicator in the complex Medicaid population. Quality improvement efforts should focus on care continuity during transitions and consider population-specific factors that influence readmission. Optimum post-discharge utilization in the Medicaid population requires a balance between outpatient, emergency and inpatient services to improve access and continuity. PMID:26730804

  3. The Efficacy of Asthma Case Management in an Urban School District in Reducing School Absences and Hospitalizations for Asthma

    ERIC Educational Resources Information Center

    Levy, Marian; Heffner, Brenda; Stewart, Tara; Beeman, Gail

    2006-01-01

    Pediatric asthma rates are reaching epidemic proportions, adversely affecting children's quality of life, educational potential, and health care costs, especially those in the inner city. This study evaluated the effectiveness of a school-based asthma case management (CM) approach with medically undeserved inner-city children attending Memphis…

  4. The Effectiveness of Stress Management and Test-Taking Workshops in Reducing Test Anxiety of Community College Students.

    ERIC Educational Resources Information Center

    Price, Elsa C.

    A study was conducted to determine the effectiveness of a Stress Management Seminar and a Test-Taking Skills Workshop in improving the scores of pre-nursing and guidance examinees at Wallace Community College in Dothan, Alabama. The 73 subjects took the Pre-Nursing and Guidance Examination (PNGE) in June 1984, September 1984, or January 1985.…

  5. Has the Shift to Managed Care Reduced Medicaid Expenditures? Evidence from State and Local-Level Mandates

    ERIC Educational Resources Information Center

    Duggan, Mark; Hayford, Tamara

    2013-01-01

    From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan. Theoretically, it is ambiguous whether the shift from…

  6. Manure and inorganic fertilizer management practices for reducing methane and nitrous oxide emissions in conservation tillage systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Conservation tillage and use of poultry litter (PL) as a fertilizer are widely being recommended for soil conservation, C sequestration, and environmentally sustainable animal waste disposal methods in the southeastern U.S. There is a need to develop and evaluate fertilizer management practices for...

  7. Water management impacts on arsenic speciation and iron-reducing bacteria in contrasting rice-rhizosphere compartments

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rice cultivated on arsenic (As) contaminated-soils usually accumulates variable grain-As concentrations, as impacted by genotypic differences, soil variables and crop management. A field-scale experiment was conducted to study the impact of intermittent and continuous flooding on As speciation and m...

  8. Management of Sodium-reduced Meals at Worksite Cafeterias: Perceptions, Practices, Barriers, and Needs among Food Service Personnel

    PubMed Central

    Lee, Jounghee; Park, Sohyun

    2015-01-01

    Objectives The sodium content of meals provided at worksite cafeterias is greater than the sodium content of restaurant meals and home meals. The objective of this study was to assess the relationships between sodium-reduction practices, barriers, and perceptions among food service personnel. Methods We implemented a cross-sectional study by collecting data on perceptions, practices, barriers, and needs regarding sodium-reduced meals at 17 worksite cafeterias in South Korea. We implemented Chi-square tests and analysis of variance for statistical analysis. For post hoc testing, we used Bonferroni tests; when variances were unequal, we used Dunnett T3 tests. Results This study involved 104 individuals employed at the worksite cafeterias, comprised of 35 men and 69 women. Most of the participants had relatively high levels of perception regarding the importance of sodium reduction (very important, 51.0%; moderately important, 27.9%). Sodium reduction practices were higher, but perceived barriers appeared to be lower in participants with high-level perception of sodium-reduced meal provision. The results of the needs assessment revealed that the participants wanted to have more active education programs targeting the general population. The biggest barriers to providing sodium-reduced meals were use of processed foods and limited methods of sodium-reduced cooking in worksite cafeterias. Conclusion To make the provision of sodium-reduced meals at worksite cafeterias more successful and sustainable, we suggest implementing more active education programs targeting the general population, developing sodium-reduced cooking methods, and developing sodium-reduced processed foods. PMID:27169011

  9. Towards Excellence in Asthma Management: Final report of an eight-year program aimed at reducing care gaps in asthma management in Quebec

    PubMed Central

    Boulet, Louis-Philippe; Dorval, Eileen; Labrecque, Manon; Turgeon, Michel; Montague, Terrence; Thivierge, Robert L

    2008-01-01

    BACKGROUND AND OBJECTIVES: Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or ‘care gaps’, in which all stakeholders of the health care system (including patients) are involved, was proposed. METHODS: Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed. RESULTS: Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners. CONCLUSIONS: Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care. PMID:18818784

  10. Can parental monitoring and peer management reduce the selection or influence of delinquent peers? Testing the question using a dynamic social network approach.

    PubMed

    Tilton-Weaver, Lauree C; Burk, William J; Kerr, Margaret; Stattin, Håkan

    2013-11-01

    We tested whether parents can reduce affiliation with delinquent peers through 3 forms of peer management: soliciting information, monitoring rules, and communicating disapproval of peers. We examined whether peer management interrupted 2 peer processes: selection and influence of delinquent peers. Adolescents' feelings of being overcontrolled by parents were examined as an additional moderator of delinquent selection and influence. Using network data from a community sample (N = 1,730), we tested whether selection and influence processes varied across early, middle, and late adolescent cohorts. Selection and influence of delinquent peers were evident in all 3 cohorts and did not differ in strength. Parental monitoring rules reduced the selection of delinquent peers in the oldest cohort. A similar effect was found in the early adolescent cohort, but only for adolescents who did not feel overcontrolled by parents. Monitoring rules increased the likelihood of selecting a delinquent friend among those who felt overcontrolled. The effectiveness of communicating disapproval was also mixed: in the middle adolescent network, communicating disapproval increased the likelihood of an adolescent selecting a delinquent friend. Among late adolescents, high levels of communicating disapproval were effective, reducing the influence of delinquent peers for adolescents reporting higher rates of delinquency. For those who reported lower levels of delinquency, high levels of communicating disapproval increased the influence of delinquent peers. The results of this study suggest that the effectiveness of monitoring and peer management depend on the type of behavior, the timing of its use, and whether adolescents feel overcontrolled by parents. PMID:23421802

  11. Energy-Smart Building Choices: How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money (Revision)

    SciTech Connect

    Not Available

    2002-02-01

    Operating a typical school today is no easy task for facilities managers and business officials. You're expected to deliver increased services with constrained operating budgets. Many schools stay open for longer hours to accommodate community use of the facilities. Dilapidated buildings and systems gobble up energy, yet in many districts, maintenance needs are overshadowed by the need for expansion or new construction to serve growing student populations and changing educational needs.

  12. Population Care Management and Team-Based Approach to Reduce Racial Disparities among African Americans/Blacks with Hypertension

    PubMed Central

    Bartolome, Rowena E; Chen, Agnes; Handler, Joel; Platt, Sharon Takeda; Gould, Bernice

    2016-01-01

    Objectives: At Kaiser Permanente, national Equitable Care Health Outcomes (ECHO) Reports with a baseline measurement of 16 Healthcare Effectiveness Data and Information Set measures stratified by race and ethnicity showed a disparity of 8.1 percentage points in blood pressure (BP) control rates between African- American/black (black) and white members. The aims of this study were to describe a population care management team-based approach to improve BP control for large populations and to explain how a culturally tailored, patient-centered approach can address this racial disparity. Methods: These strategies were implemented through: 1) physician-led educational programs on treatment intensification, medication adherence, and consistent use of clinical practice guidelines; 2) building strong care teams by defining individual roles and responsibilities in hypertension management; 3) redesign of the care delivery system to expand access; and 4) programs on culturally tailored communication tools and self-management. Results: At a physician practice level where 65% of patients with hypertension were black, BP control rates (< 140/90 mmHg) for blacks improved from 76.6% to 81.4%, and control rates for whites increased from 82.9% to 84.2%. The racial gap narrowed from 6.3% to 2.8%. As these successful practices continue to spread throughout the program, the health disparity gap in BP control has decreased by 50%, from 8.1% to 3.9%. Conclusion: A sustainable program to collect self-reported race, ethnicity, and language preference data integrated with successful population care management programs provided the foundation for addressing health disparities. Cultural tailoring of a multilevel team-based approach closed the gap for blacks with hypertension. PMID:26824963

  13. Comparative losses of nutrients and sediment in surface runoff from watersheds in conservation tillage and reduced-input management practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Conservation tillage can reduce soil losses resulting from corn and soybean production compared to conventional tillage. There is a concern, however, that this can result in increased nutrient losses, particularly with no-till, due to lack of incorporation of surface-applied mineral fertilizers. The...

  14. How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money. Energy-Smart Building Choices.

    ERIC Educational Resources Information Center

    Department of Energy, Washington, DC.

    This guide addresses contributions that school facility administrators and business officials can make in an effort to reduce operating costs and free up money for capital improvements. The guide explores opportunities available to utilize energy-saving strategies at any stage in a building's life, from its initial design phase through renovation.…

  15. Development and demonstration of techniques for reducing occupational radiation doses during refueling outages. Tasks 7A/7B. Advanced outage management and radiation exposure control

    SciTech Connect

    Not Available

    1985-03-01

    Objectives of Tasks 7A and 7B were to develop and demonstrate computer based systems to assist plant management and staff in utilizing information more effectively to reduce occupational exposures received as a result of refueling outages, and to shorten the duration of the outage. The Advanced Outage Management (AOM) Tool (Task 7A) is an automated outage planning system specifically designed to meet the needs of nuclear plant outage management. The primary objective of the AOM tool is to provide a computerized system that can manipulate the information typically associated with outage planning and scheduling to furnish reports and schedules that more accurately project the future course of the outage. The Radiation Exposure Control (REC) Tool (Task 7B) is a computerized personnel radiation exposure accounting and management system designed to enable nuclear plant management to project and monitor total personnel radiation exposure on a real-time basis. The two systems were designed to operate on the same computer system and interface through a common database that enables information sharing between plant organizations not typically interfaced. This interfacing provides outage planners with a means of incorporating occupational radiation exposure as a factor for making decisions on the course of an outage.

  16. Managing potential drug-drug interactions between gastric acid-reducing agents and antiretroviral therapy: experience from a large HIV-positive cohort.

    PubMed

    Lewis, J M; Stott, K E; Monnery, D; Seden, K; Beeching, N J; Chaponda, M; Khoo, S; Beadsworth, M B J

    2016-02-01

    Drug-drug interactions between antiretroviral therapy and other drugs are well described. Gastric acid-reducing agents are one such class. However, few data exist regarding the frequency of and indications for prescription, nor risk assessment in the setting of an HIV cohort receiving antiretroviral therapy. To assess prevalence of prescription of gastric acid-reducing agents and drug-drug interaction within a UK HIV cohort, we reviewed patient records for the whole cohort, assessing demographic data, frequency and reason for prescription of gastric acid-reducing therapy. Furthermore, we noted potential drug-drug interaction and whether risk had been documented and mitigated. Of 701 patients on antiretroviral therapy, 67 (9.6%) were prescribed gastric acid-reducing therapy. Of these, the majority (59/67 [88.1%]) were prescribed proton pump inhibitors. We identified four potential drug-drug interactions, which were appropriately managed by temporally separating the administration of gastric acid-reducing agent and antiretroviral therapy, and all four of these patients remained virally suppressed. Gastric acid-reducing therapy, in particular proton pump inhibitor therapy, appears common in patients prescribed antiretroviral therapy. Whilst there remains a paucity of published data, our findings are comparable to those in other European cohorts. Pharmacovigilance of drug-drug interactions in HIV-positive patients is vital. Education of patients and staff, and accurate data-gathering tools, will enhance patient safety. PMID:25721922

  17. Reducing the basin vulnerability by land management practices under past and future climate: a case study of the Nam Ou River Basin, Lao PDR

    NASA Astrophysics Data System (ADS)

    Maharjan, M.; Babel, M. S.; Maskey, S.

    2014-08-01

    This research evaluates different land management practices for the Nam Ou River Basin in Northern Laos for reducing vulnerability of the basin due to erosion and sediment yield under existing and future climate conditions. We use climate projection data (precipitation and temperature) from three general circulation models (GCMs) for three greenhouse gas emission scenarios (GHGES), namely B1, A1B and A2 and three future periods, namely 2011-2030, 2046-2065 and 2080-2099. These large resolution GCM data are downscaled using the Long Ashton Research Station-Weather Generator (LARS-WG). The Soil and Water Assessment Tool (SWAT), which is a process based hydrological model, is used to simulate discharge and sediment yield and a threshold value of annual sediment yield is applied to identify vulnerable sub-basins. Results show that the change in the annual precipitation is expected to be between -7.60 to 2.64% in 2011-2030, -8.98 to 11.85% in 2046-2065, and -11.04 to 25.84% in 2080-2099. In the meantime, the changes in mean monthly temperature vary from 0.3 to 1.3 °C in the 2011-2030, 1.3 to 2.9 °C in the 2046-2065 and 1.9 to 4.9 °C in the 2080-2099. Five sub-basins are identified vulnerable (critical) under the current climate. Our results show that terracing is the most effective land management practice to reduce sediment yield in these sub-basins followed by strip-cropping and filter strip. Appropriate land management practices applied under future climate scenarios show significant reduction in sediment yield (i.e. up to the tolerance limit) except for some sub-basins. In these exceptional sub-basins, designing an optimum combination of management practices is essential to reduce the vulnerability of the basin.

  18. Many-objective reservoir policy identification and refinement to reduce policy inertia and myopia in water management

    NASA Astrophysics Data System (ADS)

    Giuliani, M.; Herman, J. D.; Castelletti, A.; Reed, P.

    2014-04-01

    This study contributes a decision analytic framework to overcome policy inertia and myopia in complex river basin management contexts. The framework combines reservoir policy identification, many-objective optimization under uncertainty, and visual analytics to characterize current operations and discover key trade-offs between alternative policies for balancing competing demands and system uncertainties. The approach is demonstrated on the Conowingo Dam, located within the Lower Susquehanna River, USA. The Lower Susquehanna River is an interstate water body that has been subject to intensive water management efforts due to competing demands from urban water supply, atomic power plant cooling, hydropower production, and federally regulated environmental flows. We have identified a baseline operating policy for the Conowingo Dam that closely reproduces the dynamics of current releases and flows for the Lower Susquehanna and thus can be used to represent the preferences structure guiding current operations. Starting from this baseline policy, our proposed decision analytic framework then combines evolutionary many-objective optimization with visual analytics to discover new operating policies that better balance the trade-offs within the Lower Susquehanna. Our results confirm that the baseline operating policy, which only considers deterministic historical inflows, significantly overestimates the system's reliability in meeting the reservoir's competing demands. Our proposed framework removes this bias by successfully identifying alternative reservoir policies that are more robust to hydroclimatic uncertainties while also better addressing the trade-offs across the Conowingo Dam's multisector services.

  19. Can telemonitoring reduce hospitalization and cost of care? A health plan's experience in managing patients with heart failure.

    PubMed

    Maeng, Daniel D; Starr, Alison E; Tomcavage, Janet F; Sciandra, Joann; Salek, Doreen; Griffith, David

    2014-12-01

    Telemonitoring provides a potentially useful tool for disease and case management of those patients who are likely to benefit from frequent and regular monitoring by health care providers. Since 2008, Geisinger Health Plan (GHP) has implemented a telemonitoring program that specifically targets those members with heart failure. This study assesses the impact of this telemonitoring program by examining claims data of those GHP Medicare Advantage plan members who were enrolled in the program, measuring its impact in terms of all-cause hospital admission rates, readmission rates, and total cost of care. The results indicate significant reductions in probability of all-cause admission (odds ratio [OR] 0.77; P<0.01), 30-day and 90-day readmission (OR 0.56, 0.62; P<0.05), and cost of care (11.3%; P<0.05). The estimated return on investment was 3.3. These findings imply that telemonitoring can be an effective add-on tool for managing elderly patients with heart failure. PMID:24865986

  20. Assessing the risk of alternative management strategies in a Mediterranean fishery: protecting the younger vs reducing fishing effort

    PubMed Central

    Politikos, D.V.; Maravelias, C.D.; Tzanetis, D.E.

    2013-01-01

    A stochastic age-structured population model was developed to explore biologically favourable levels of effort and closing periods within the sardine pelagic fishery in the eastern Mediterranean Sea. Results suggested that the developed age-structured model captured the observed biomass fluctuations and catches reasonably well and represents the first comprehensive investigation of alternative management strategies for eastern Mediterranean sardine fishery that include stochasticity. The present study provided direct evidence for the importance of the correct timing of the temporal fishing ban. Significant benefits were found both in terms of biomass and catch from a corrective shift in the fishing closed period. The current findings suggested that protecting the younger age groups from fishing in the period October–December, by shifting the ban period earlier than December may profit, biologically, the stock and economically the fishing sector. Progressive reductions in fishing mortality/effort also yield significant positive biological and fishery benefits in the short term. PMID:23931664

  1. Tailored Activities to Manage Neuropsychiatric Behaviors in Persons with Dementia and Reduce Caregiver Burden: A Randomized Pilot Study

    PubMed Central

    Gitlin, Laura N.; Winter, Laraine; Burke, Janice; Chernett, Nancy; Dennis, Marie P.; Hauck, Walter W.

    2009-01-01

    Objective To test whether the Tailored Activity Program for at-home dementia patients reduces neuropsychiatric behaviors and caregiver burden. Method A prospective, two-group controlled pilot study with 60 dyads randomized to treatment or wait-list control. Dyads were interviewed at baseline and 4 months (trial endpoint); control participants then received intervention and were reassessed 4 months later. The 8-session occupational therapy intervention involved neuropsychological and functional testing from which activities were customized and instruction in use provided to caregivers. Results At 4-months, compared to controls, intervention caregivers reported reduced frequency of behaviors (p = .010; Cohen’s d = .72), specifically for shadowing (p = .003, Cohen’s d = 3.10) and repetitive questioning (p = .23, Cohen’s d = 1.22); greater activity engagement (p = .029, Cohen’s d = .61); and ability to keep busy (p = .017, Cohen’s d = .71). Also, fewer intervention caregivers reported agitation (p = .014, Cohen’s d = .75) or argumentation (p = .010, Cohen’s d = .77). Caregiver benefits included fewer hours doing things (p = .005, Cohen’s d = 1.14) and being on duty (p = .001, Cohen’s d = 1.01), greater mastery (p = .013, Cohen’s d = .55), self-efficacy (p = .011, Cohen’s d = .74), and use of simplification techniques (p = .023, Cohen’s d = .71). Wait-list control participants showed similar benefits for behavioral frequency following intervention. Conclusions Results suggest clinically-relevant benefits for both dementia patients and caregivers, with treatment minimizing the occurrence of behaviors that commonly trigger nursing home placement. PMID:18310553

  2. Efforts to Reduce International Space Station Crew Maintenance for the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

    NASA Technical Reports Server (NTRS)

    Steele, John W.; Etter, David; Rector, Tony; Boyle, Robert; Vandezande, Christopher

    2013-01-01

    The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with on-orbit ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post-Shuttle 6-year service life.

  3. Modelling the potential of slurry management technologies to reduce the constraints of environmental legislation on pig production.

    PubMed

    Hutchings, Nicholas J; ten Hoeve, Marieke; Jensen, Rikke; Bruun, Sander; Søtoft, Lene F

    2013-11-30

    Limits on land applications of slurry nitrogen (N) and phosphorus (P) are used to restrict losses of nutrients caused by livestock production. Here, we used a model to assess technologies that enable a more even geographic distribution of slurry nutrients to land. Technologies included were screw press slurry separation, with or without solid fraction composting, centrifuge separation with or without liquid fraction ammonia (NH3) stripping, and anaerobic digestion. Regulatory constraints were placed first on the application in slurry of N, then P, then N and P both on the producing (donor) and receiving (recipient) farms. Finally, a constraint preventing an increase in donor farm NH3 emissions was imposed. Separation had little effect on N losses per unit mass of slurry, but NH3 stripping led to a reduction. Centrifuge separation allowed a greater increase in pig production than a screw press, especially with P regulation. NH3 stripping was only advantageous with N regulation or when combined with NH3 scrubbing of pig housing ventilation air, when donor farm NH3 emissions were a constraint. There was a production penalty for using composting or anaerobic digestion. The choice of appropriate slurry management option therefore depends on the focus of the regulation. Nuanced and therefore complex regulations are necessary to take advantage of synergies and avoid cross-policy conflicts and incongruencies. PMID:24184986

  4. Managed European-Derived Honey Bee, Apis mellifera sspp, Colonies Reduce African-Matriline Honey Bee, A. m. scutellata, Drones at Regional Mating Congregations

    PubMed Central

    Mortensen, Ashley N.; Ellis, James D.

    2016-01-01

    African honey bees (Apis mellifera scutellata) dramatically changed the South American beekeeping industry as they rapidly spread through the Americas following their introduction into Brazil. In the present study, we aimed to determine if the management of European-derived honey bees (A. mellifera sspp.) could reduce the relative abundance of African-matriline drones at regional mating sites known as drone congregation areas (DCAs). We collected 2,400 drones at six DCAs either 0.25 km or >2.8 km from managed European-derived honey bee apiaries. The maternal ancestry of each drone was determined by Bgl II enzyme digestion of an amplified portion of the mitochondrial Cytochrome b gene. Furthermore, sibship reconstruction via nuclear microsatellites was conducted for a subset of 1,200 drones to estimate the number of colonies contributing drones to each DCA. Results indicate that DCAs distant to managed European apiaries (>2.8 km) had significantly more African−matriline drones (34.33% of the collected drones had African mitochondrial DNA) than did DCAs close (0.25 km) to managed European apiaries (1.83% of the collected drones had African mitochondrial DNA). Furthermore, nuclear sibship reconstruction demonstrated that the reduction in the proportion of African matriline drones at DCAs near apiaries was not simply an increase in the number of European matriline drones at the DCAs but also the result of fewer African matriline colonies contributing drones to the DCAs. Our data demonstrate that the management of European honey bee colonies can dramatically influence the proportion of drones with African matrilines at nearby drone congregation areas, and would likely decreasing the probability that virgin European queens will mate with African drones at those drone congregation areas. PMID:27518068

  5. Managed European-Derived Honey Bee, Apis mellifera sspp, Colonies Reduce African-Matriline Honey Bee, A. m. scutellata, Drones at Regional Mating Congregations.

    PubMed

    Mortensen, Ashley N; Ellis, James D

    2016-01-01

    African honey bees (Apis mellifera scutellata) dramatically changed the South American beekeeping industry as they rapidly spread through the Americas following their introduction into Brazil. In the present study, we aimed to determine if the management of European-derived honey bees (A. mellifera sspp.) could reduce the relative abundance of African-matriline drones at regional mating sites known as drone congregation areas (DCAs). We collected 2,400 drones at six DCAs either 0.25 km or >2.8 km from managed European-derived honey bee apiaries. The maternal ancestry of each drone was determined by Bgl II enzyme digestion of an amplified portion of the mitochondrial Cytochrome b gene. Furthermore, sibship reconstruction via nuclear microsatellites was conducted for a subset of 1,200 drones to estimate the number of colonies contributing drones to each DCA. Results indicate that DCAs distant to managed European apiaries (>2.8 km) had significantly more African-matriline drones (34.33% of the collected drones had African mitochondrial DNA) than did DCAs close (0.25 km) to managed European apiaries (1.83% of the collected drones had African mitochondrial DNA). Furthermore, nuclear sibship reconstruction demonstrated that the reduction in the proportion of African matriline drones at DCAs near apiaries was not simply an increase in the number of European matriline drones at the DCAs but also the result of fewer African matriline colonies contributing drones to the DCAs. Our data demonstrate that the management of European honey bee colonies can dramatically influence the proportion of drones with African matrilines at nearby drone congregation areas, and would likely decreasing the probability that virgin European queens will mate with African drones at those drone congregation areas. PMID:27518068

  6. Impact of the Creation and Implementation of a Clinical Management Guideline for Personality Disorders in Reducing Use of Mechanical Restraints in a Psychiatric Inpatient Unit

    PubMed Central

    Fernandez-Rivas, Aranzazu; Bustamante, Sonia; Rico-Vilademoros, Fernando; Vivanco, Esther; Martinez, Karmele; Angel Vecino, Miguel; Martín, Melba; Herrera, Sonia; Rodriguez, Jorge; Saenz, Carlos

    2014-01-01

    Objective: To evaluate the impact of the implementation of a guideline for the management of personality disorders on reducing the frequency of use of mechanical restraints in a psychiatric inpatient unit. Method: This retrospective study was conducted in a psychiatric inpatient unit with 42 beds, which serves an urban area of 330,000 inhabitants. The sample consisted of all patients with a clinical diagnosis of personality disorder (DSM-IV-TR criteria) who were admitted to the unit from January 2010 to December 2010 and from January 2011 to December 2011 (ie, before and after, respectively, the implementation of the guideline). The guideline focused on cluster B disorders and follows a psychodynamic perspective. Results: Restraint use was reduced from 38 of 87 patients with personality disorders (43.7%) to 3 of 112 (2.7%), for a relative risk of 0.06 (95% CI, 0.02–0.19) and an absolute risk reduction of 41% (95% CI, 29.9%–51.6%). The risk of being discharged against medical advice increased after the intervention, with a relative risk of 1.84 (95% CI, 0.96–3.51). Restraint use in patients with other diagnoses was also reduced to a similar extent. Conclusions: The use of mechanical restraints was dramatically reduced after the implementation of a clinical practice guideline on personality disorders, suggesting that these coercive measures might be decreased in psychiatric inpatient units. PMID:25834763

  7. Investigating the potential to reduce flood risk through catchment-based land management techniques and interventions in the River Roe catchment, Cumbria,UK

    NASA Astrophysics Data System (ADS)

    Pearson, Callum; Reaney, Sim; Bracken, Louise; Butler, Lucy

    2015-04-01

    Throughout the United Kingdom flood risk is a growing problem and a significant proportion of the population are at risk from flooding throughout the country. Across England and Wales over 5 million people are believed to be at risk from fluvial, pluvial or coastal flooding (DEFRA, 2013). Increasingly communities that have not dealt with flooding before have recently experienced significant flood events. The communities of Stockdalewath and Highbridge in the Roe catchment, a tributary of the River Eden in Cumbria, UK, are an excellent example. The River Roe has a normal flow of less than 5m3 sec-1 occurring 97 percent of the time however there have been two flash floods of 98.8m3 sec-1 in January 2005 and 86.9m3 sec-1 in May 2013. These two flash flood events resulted in the inundation of numerous properties within the catchment with the 2013 event prompting the creation of the Roe Catchment Community Water Management Group which aims are to deliver a sustainable approach to managing the flood risk. Due to the distributed rural population the community fails the cost-benefit analysis for a centrally funded flood risk mitigation scheme. Therefore the at-risk community within the Roe catchment have to look for cost-effective, sustainable techniques and interventions to reduce the potential negative impacts of future events; this has resulted in a focus on natural flood risk management. This research investigates the potential to reduce flood risk through natural catchment-based land management techniques and interventions within the Roe catchment; providing a scientific base from with further action can be enacted. These interventions include changes to land management and land use, such as soil aeration and targeted afforestation, the creation of runoff attenuation features and the construction of in channel features, such as debris dams. Natural flood management (NFM) application has been proven to be effective when reducing flood risk in smaller catchments and the

  8. Drug-Related Arrest Rates and Spatial Access to Syringe Exchange Programs in New York City Health Districts: Combined Effects on the Risk of Injection-Related Infections among Injectors

    PubMed Central

    Jarlais, Don C Des; Tempalski, Barbara; Bossak, Brian H; Ross, Zev; Friedman, Samuel R

    2011-01-01

    Drug-related law enforcement activities may undermine the protective effects of syringe exchange programs (SEPs) on local injectors’ risk of injection-related infections. We explored the spatial overlap of drug-related arrest rates and access to SEPs over time (1995-2006) in New York City health districts, and used multilevel models to investigate the relationship of these two district-level exposures to the odds of injecting with an unsterile syringe. Districts with better SEP access had higher arrest rates, and arrest rates undermined SEPs’ protective relationship with unsterile injecting. Drug-related enforcement strategies targeting drug users should be de-emphasized in areas surrounding SEPs. PMID:22047790

  9. Potential of forest management to reduce French carbon emissions - regional modelling of the French forest carbon balance from the forest to the wood.

    NASA Astrophysics Data System (ADS)

    Valade, A.; Luyssaert, S.; Bellassen, V.; Vallet, P.

    2015-12-01

    In France the low levels of forest harvest (40 Mm3 per year over a volume increment of 89Mm3) is frequently cited to push for a more intensive management of the forest that would help reducing CO2 emissions. This reasoning overlooks the medium-to-long-term effects on the carbon uptake at the national scale that result from changes in the forest's structure and delayed emissions from products decay and bioenergy burning, both determinant for the overall C fluxes between the biosphere and the atmosphere. To address the impacts of an increase in harvest removal on biosphere-atmosphere carbon fluxes at national scale, we build a consistent regional modeling framework to integrate the forest-carbon system from photosynthesis to wood uses. We aim at bridging the gap between regional ecosystem modeling and land managers' considerations, to assess the synergistic and antagonistic effects of management strategies over C-based forest services: C-sequestration, energy and material provision, fossil fuel substitution. For this, we built on inventory data to develop a spatial forest growth simulator and design a novel method for diagnosing the current level of management based on stand characteristics (density, quadratic mean diameter or exploitability). The growth and harvest simulated are then processed with a life cycle analysis to account for wood transformation and uses. Three scenarii describe increases in biomass removals either driven by energy production target (set based on national prospective with a lock on minimum harvest diameters) or by changes in management practices (shorter or longer rotations, management of currently unmanaged forests) to be compared with business as usual simulations. Our management levels' diagnostics quantifies undermanagement at national scale and evidences the large weight of ownership-based undermanagement with an average of 26% of the national forest (between 10% and 40% per species) and thus represents a huge potential wood resource

  10. Organic matter and water management strategies to reduce methane and nitrous oxide emissions from rice fields in Vietnam

    NASA Astrophysics Data System (ADS)

    Pandey, A.

    2014-12-01

    The reduction of CH4 and N2O emissions from rice paddies is of utmost importance in minimizing the impact of rice production on global warming. A field experiment was therefore conducted in farmers' field in Hanoi, Vietnam to examine whether the use of straw compost or straw biochar, in combination with the safe alternate wetting and drying (AWD) has the potential to suppress both CH4 and N2O emissions from rice paddies while maintaining the rice yield. The study compared the proposed strategies with local farmers' practice of permanent flooding (PF) and farmyard manure (FYM) incorporation, respectively. A control treatment without organic matter incorporation in both AWD and PF water regimes was also included in the study; all treatments received equal amounts of mineral fertilizer. Gas emissions were monitored using the closed chamber method at seven-day intervals during the first 50 days and at 15-day intervals thereafter. Addition of FYM, straw compost and biochar increased CH4 emissions by 230 %, 150 % and 38 %, respectively, when compared with the control treatments in both the AWD and PF water regimes. Within AWD, FYM increased N2O emissions by 30 %, straw compost and biochar displayed similar amount of N2O emissions as the control treatment. Within PF, N2O emissions under FYM and straw compost were 40 % and 35 % higher than the control treatment, respectively, and biochar once again displayed similar amount of N2O emissions as the control treatment. Yield difference was not significant (P > 0.05) between any of the treatments. These results indicated that the straw compost incorporation might not reduce the global warming potential (GWP) and yield-scaled GWP of rice production, whereas biochar in combination with AWD has the potential to maintain the GWP and yield-scaled GWP of rice production at lower level than the farmers' practice.

  11. Identification of quality management practices to reduce the incidence of retail beef tenderness problems: development and evaluation of a prototype quality system to produce tender beef.

    PubMed

    Tatum, J D; Belk, K E; George, M H; Smith, G C

    1999-08-01

    A prototype quality system for ensuring beef tenderness was designed and tested. The test population of cattle was genetically diverse, but it was constrained to include youthful (14- to 17-mo-old) steers with no more than 3/8 Bos indicus inheritance. Feeding and preharvest management of the cattle were consistent with procedures recommended for production of grain-finished beef of an acceptable quality level. In addition, the target endpoint for harvest (11-mm external fat thickness over the longissimus at the 12th rib) resulted in production of mostly Select and low Choice beef carcasses; 92% of the resulting carcasses qualified for these two grade levels. Application of the prototype quality system reduced the expected rate of nonconformance to desired tenderness specifications from about one in four loin steaks (23% for top sirloins and 26% for strip loins) to approximately one in eight loin steaks (13% for top sirloins and 12% for strip loins). Tenderness comparisons among sires suggested that the rate of nonconformance for strip loin steaks might be reduced even further by control of genetic inputs into the system. Use of process control in a quality management system was demonstrated to be an effective approach for assurance of beef tenderness. PMID:10461989

  12. Forest carbon response to management scenarios intended to mitigate GHG emissions and reduce fire impacts in the US West Coast region

    NASA Astrophysics Data System (ADS)

    Hudiburg, T. W.; Law, B. E.; Thornton, P. E.; Luyssaert, S.

    2012-12-01

    US West coast forests are among the most carbon dense biomes in the world and the potential for biomass accumulation in mesic coastal forests is the highest recorded (Waring and Franklin 1979, Hudiburg et al. 2009). Greenhouse gas (GHG) mitigation strategies have recently expanded to include forest woody biomass as bioenergy, with the expectation that this will also reduce forest mortality. We examined forest carbon response and life cycle assessment (LCA) of net carbon emissions following varying combinations of bioenergy management scenarios in Pacific Northwest forests for the period from 2010-2100. We use the NCAR CLM4 model combined with a regional atmospheric forcing dataset and account for future environmental change using the IPCC RCP4.5 and RCP 8.5 scenarios. Bioenergy management strategies include a repeated thinning harvest, a repeated clearcut harvest, and a single salvage harvest in areas with projected insect-related mortality. None of the bioenergy management scenarios reduce net emissions to the atmosphere compared to continued business-as-usual harvest (BAU) by the end of the 21st century. Forest regrowth and reduced fire emissions are not large enough to balance the wood removals from harvest. Moreover, the substitution of wood for fossil fuel energy and products is not large enough to offset the wood losses through decomposition and combustion. However, in some ecoregions (Blue Mountains and East Cascades), emissions from the thinning harvests begin to improve over BAU at the end of the century and could lead to net reductions in those ecoregions over a longer time period (> 100 years). For salvage logging, there is no change compared to BAU emissions by the end of the 21st century because the treatment area is minimal compared to the other treatments and only performed once. These results suggest that managing forests for carbon sequestration will need to include a variety of approaches accounting for forest baseline conditions and in some

  13. Does case management for patients with heart failure based in the community reduce unplanned hospital admissions? A systematic review and meta-analysis

    PubMed Central

    Huntley, A L; Johnson, R; King, A; Morris, R W; Purdy, S

    2016-01-01

    Objectives The aim of this systematic review of randomised controlled trials (RCTs) and controlled trials (non-RCTs, NRCTs) is to investigate the effectiveness and related costs of case management (CM) for patients with heart failure (HF) predominantly based in the community in reducing unplanned readmissions and length of stay (LOS). Setting CM initiated either while as an inpatient, or on discharge from acute care hospitals, or in the community and then continuing on in the community. Participants Adults with a diagnosis of HF and resident in Organisation for Economic Co-operation and Development countries. Intervention CM based on nurse coordinated multicomponent care which is applicable to the primary care-based health systems. Primary and secondary outcomes Primary outcomes of interest were unplanned (re)admissions, LOS and any related cost data. Secondary outcomes were primary healthcare resources. Results 22 studies were included: 17 RCTs and 5 NRCTs. 17 studies described hospital-initiated CM (n=4794) and 5 described community-initiated CM of HF (n=3832). Hospital-initiated CM reduced readmissions (rate ratio 0.74 (95% CI 0.60 to 0.92), p=0.008) and LOS (mean difference −1.28 days (95% CI −2.04 to −0.52), p=0.001) in favour of CM compared with usual care. 9 trials described cost data of which 6 reported no difference between CM and usual care. There were 4 studies of community-initiated CM versus usual care (2 RCTs and 2 NRCTs) with only the 2 NRCTs showing a reduction in admissions. Conclusions Hospital-initiated CM can be successful in reducing unplanned hospital readmissions for HF and length of hospital stay for people with HF. 9 trials described cost data; no clear difference emerged between CM and usual care. There was limited evidence for community-initiated CM which suggested it does not reduce admission. PMID:27165648

  14. A job safety program for construction workers designed to reduce the potential for occupational injury using tool box training sessions and computer-assisted biofeedback stress management techniques.

    PubMed

    Johnson, Kenneth A; Ruppe, Joan

    2002-01-01

    This project was conducted with a multicultural construction company in Hawaii, USA. The job duties performed included drywall and carpentry work. The following objectives were selected for this project: (a) fire prevention training and inspection of first aid equipment; (b) blood-borne pathogen training and risk evaluation; (c) ergonomic and risk evaluation intervention program; (d) electrical safety training and inspection program; (e) slips, trips, and falls safety training; (f) stress assessment and Personal Profile System; (g) safety and health program survey; (h) improving employee relations and morale by emphasizing spirituality; and (i) computer-assisted biofeedback stress management training. Results of the project indicated that observed safety hazards, reported injuries, and levels of perceived stress. were reduced for the majority of the population. PMID:12189103

  15. Implementing reduced-risk integrated pest management in fresh-market cabbage: improved net returns via scouting and timing of effective control.

    PubMed

    Burkness, Eric C; Hutchison, W D

    2008-04-01

    During 1998-2001, field studies were done to assess the efficacy of an integrated pest management (IPM) program using an action threshold and "reduced-risk" insecticides. The IPM program was compared with a conventional grower-based program. Program performance was evaluated based on management of Trichoplusia ni (Hiibner), Pieris (=Artogeia) rapae (L.), and Plutella xylostella (L.), as well as the economic impact of each program on net returns. The action threshold used in the IPM program consisted of 10% plants infested with T. ni larvae, based on previous small-plot experiment station trials. In all years of the study, the IPM program resulted in significantly lower percentages of plants infested than the conventional program or untreated check. The mean reduction in insecticide applications for the IPM program compared with the conventional program was 23.5%, whereas, on average, the costs of the IPM program were 46.0% higher than the conventional program. Pest reduction in the IPM program resulted in an average of 10.5% higher marketable yields than the conventional program. Percentages of marketable heads in the IPM program ranged from 82 to 99% and from 63 to 96% in the conventional program. Mean net returns for the IPM program exceeded the conventional program by $984.20/ha. These results indicated that the IPM program reduced insecticide use overall, even though costs of the IPM program, with either spinosad or indoxacarb, were sometimes higher. Overall, net returns of the IPM program were higher due to active pest scouting, improved application timing, and increases in marketable yield. Given the potential decrease in insecticide applications and increases in net profit resulting from this IPM program, additional analyses should be conducted to quantify the economic risk, or consistency of the results, to fully evaluate the benefits of the IPM program compared with a conventional program. PMID:18459412

  16. The role of sustainable agriculture and renewable-resource management in reducing greenhouse-gas emissions and increasing sinks in China and India.

    PubMed

    Pretty, J N; Ball, A S; Xiaoyun, Li; Ravindranath, N H

    2002-08-15

    This paper contains an analysis of the technical options in agriculture for reducing greenhouse-gas emissions and increasing sinks, arising from three distinct mechanisms: (i) increasing carbon sinks in soil organic matter and above-ground biomass; (ii) avoiding carbon emissions from farms by reducing direct and indirect energy use; and (iii) increasing renewable-energy production from biomass that either substitutes for consumption of fossil fuels or replaces inefficient burning of fuelwood or crop residues, and so avoids carbon emissions, together with use of biogas digesters and improved cookstoves. We then review best-practice sustainable agriculture and renewable-resource-management projects and initiatives in China and India, and analyse the annual net sinks being created by these projects, and the potential market value of the carbon sequestered. We conclude with a summary of the policy and institutional conditions and reforms required for adoption of best sustainability practice in the agricultural sector to achieve the desired reductions in emissions and increases in sinks. A review of 40 sustainable agriculture and renewable-resource-management projects in China and India under the three mechanisms estimated a carbon mitigation potential of 64.8 MtC yr(-1) from 5.5 Mha. The potential income for carbon mitigation is $324 million at $5 per tonne of carbon. The potential exists to increase this by orders of magnitude, and so contribute significantly to greenhouse-gas abatement. Most agricultural mitigation options also provide several ancillary benefits. However, there are many technical, financial, policy, legal and institutional barriers to overcome. PMID:12460495

  17. Improving efficiency and reducing costs: Design of an adaptive, seamless, and enriched pragmatic efficacy trial of an online asthma management program☆,☆☆,★

    PubMed Central

    Lu, Mei; Ownby, Dennis R.; Zoratti, Edward; Roblin, Douglas; Johnson, Dayna; Johnson, Christine Cole; Joseph, Christine L.M.

    2014-01-01

    Clinical trials are critical for medical decision-making, however, under the current paradigm, clinical trials are fraught with problems including low enrollment and high cost. Promising alternatives to increase trial efficiency and reduce costs include the use of (1) electronic initiatives that permit electronic remote data capture (EDC) for direct data collection at a site (2), electronic medical records (EMR) for patient identification and data collection, and (3) adaptive, enrichment designs with pragmatic approaches. We describe the design of a seamless, multi-site randomized Phase II/III trial to evaluate an asthma management intervention in urban adolescents with asthma. Patients are randomized, asked to access four online sessions of the intervention or control asthma management program, and are then followed for one year. The primary efficacy endpoint is self-reported asthma control as measured by the Asthma Control Test (ACT). Comparative effectiveness parametric approaches are utilized to conduct the trial in a real world setting with reduced costs. Escalated electronic initiatives are implemented for patient identification, assent, enrollment and tracking. Patient enrollment takes place during primary care visits. A centralized database with EDC is used for CRF data collection with integration of EMR data. This Phase II/III trial plans to have a total sample size of 500 patients with an interim look at the completion of Phase II (n = 250), The interim analyses include an assessment of the intervention effect, marker(s) identification and the feasibility study of EMR data as the trial CRF data collection. Patient enrollment has begun and is ongoing. PMID:24607295

  18. The impact of peer-based training on reducing radiation doses from x-ray operations in an interventional pain management clinic.

    PubMed

    Pitcher, Christopher D; Melanson, Mark A

    2010-01-01

    The purpose of this paper is to describe the measurement and characterization of the radiation exposure to the staff, patients, and the general public as a result of the operation of an interventional pain management (IPM) clinic, as well as the effectiveness of a peer-based fluoroscopy training program to keep doses as low as reasonably achievable (ALARA). During the last decade, pain management has evolved into an essential part of patient care. IPM, a subfield of pain management, uses fluoroscopic imaging in its procedures. As a result, there are 3 separate populations who could possibly receive exposure to ionizing radiation as a result of an IPM radiographic procedure: staff, patients, and the general public. Staff doses, as well as doses to the general public, are easily measured with radiation dosimetry. Conversely, it is very difficult to characterize the radiation dose to a patient during a fluoroscopic procedure and realistically it is not possible to measure patient dose directly. However, it is plausible to infer relative patient exposure from direct measurement of the physician s dose. The most common and practical way to measure the dose to members of the general public is to monitor the ambient radiation levels within a medical treatment facility and extrapolate these measurements to the general public. Ultimately, the goal is to maintain all doses (patient, physician, and the general public) using the ALARA principle. Using a Panasonic thermoluminescent dosimetry system, it was determined that a peer-based fluoroscopy training program effectively reduced the cumulative dose to clinic staff by approximately 50 percent. It was also determined that the standard building materials used in our facility provide enough shielding to keep doses to members of the general public below acceptable limits. PMID:20687029

  19. Reducing Stress through Preventive Management.

    ERIC Educational Resources Information Center

    Quick, James C.; Quick, Jonathan D.

    1979-01-01

    Two levels of prevention can be used to counter the key stressors of personnel at work; the first deals with organizational techniques and the second with individual techniques such as systematic desensitization, biofeedback, or aerobic exercise. (Author)

  20. Bayesian evaluation of budgets for endemic disease control: An example using management changes to reduce milk somatic cell count early in the first lactation of Irish dairy cows.

    PubMed

    Archer, S C; Mc Coy, F; Wapenaar, W; Green, M J

    2014-01-01

    The aim of this research was to determine budgets for specific management interventions to control heifer mastitis in Irish dairy herds as an example of evidence synthesis and 1-step Bayesian micro-simulation in a veterinary context. Budgets were determined for different decision makers based on their willingness to pay. Reducing the prevalence of heifers with a high milk somatic cell count (SCC) early in the first lactation could be achieved through herd level management interventions for pre- and peri-partum heifers, however the cost effectiveness of these interventions is unknown. A synthesis of multiple sources of evidence, accounting for variability and uncertainty in the available data is invaluable to inform decision makers around likely economic outcomes of investing in disease control measures. One analytical approach to this is Bayesian micro-simulation, where the trajectory of different individuals undergoing specific interventions is simulated. The classic micro-simulation framework was extended to encompass synthesis of evidence from 2 separate statistical models and previous research, with the outcome for an individual cow or herd assessed in terms of changes in lifetime milk yield, disposal risk, and likely financial returns conditional on the interventions being simultaneously applied. The 3 interventions tested were storage of bedding inside, decreasing transition yard stocking density, and spreading of bedding evenly in the calving area. Budgets for the interventions were determined based on the minimum expected return on investment, and the probability of the desired outcome. Budgets for interventions to control heifer mastitis were highly dependent on the decision maker's willingness to pay, and hence minimum expected return on investment. Understanding the requirements of decision makers and their rational spending limits would be useful for the development of specific interventions for particular farms to control heifer mastitis, and other

  1. Improving Managed Aquifer Recharge Operation to Reduce Nutrient Load in an Agricultural Basin: Delineation of Processes, Controls, and In-situ Potential

    NASA Astrophysics Data System (ADS)

    Schmidt, C. M.; Fisher, A.; Wheat, G.; Sharkey, J.; Los Huertos, M.; Lear, J.

    2007-12-01

    Nitrate is the most common nonpoint source pollutant in surface and ground water in the United States, and is a problem particularly in basins developed for agriculture. There is growing municipal and environmental demand for fresh water in basins that have been influenced by decades of agricultural activity. The goal of this research is to assess the potential for a managed aquifer recharge (MAR) system to improve water quality, with an emphasis on reducing the nitrate load to underlying aquifers. The Pajaro Valley Water Management Agency (PVWMA), in central coastal California, currently operates a MAR project that is permitted to divert and recharge up to 2.5 x 106 m3/yr (2000 ac-ft/year) from a slough (wetland) to augment available ground water supplies. As a result of agricultural runoff and infiltration, diverted slough water is often rich in nitrate, as is the water in the underlying aquifer. However, nitrate concentrations in water samples recovered from the aquifer soon after MAR percolation are often relatively low, suggesting that nitrate may be removed as water percolates from the pond into the aquifer. Autonomous Osmosampler systems were deployed in the recharge pond and four nearby monitoring wells, as part of a pilot study, to collect fluid samples during and after pond operation. Samples collected with these instruments recorded the chemical arrival of water in the aquifer soon after percolation began, in some cases showing a 50% reduction in the concentration of nitrate. The chemical response in the aquifer recorded by the Osmosamplers was consistent with pressure data collected simultaneously in the monitoring wells, demonstrating that Osmosamplers should be useful tools for investigating changes in water quality associated with MAR operation. As this research project becomes fully developed during the 2007-08 water year, we will install Osmosampler systems in ground water monitoring wells surrounding the pond, and will collect shallow fluid

  2. Reducing Teacher Stress.

    ERIC Educational Resources Information Center

    Docking, R. A.; Docking, E.

    1984-01-01

    Reports on a case study of inservice training conducted to enhance the teacher/student relationship and reduce teacher anxiety. Found significant improvements in attitudes, classroom management activities, and lower anxiety among teachers. (MD)

  3. Implementation of case management to reduce cardiovascular disease risk in the Stanford and San Mateo Heart to Heart randomized controlled trial: study protocol and baseline characteristics

    PubMed Central

    Ma, Jun; Lee, Ky-Van; Berra, Kathy; Stafford, Randall S

    2006-01-01

    smokers. Conclusion We have recruited an ethnically diverse, low-income cohort in which to implement a case management approach and test its efficacy and cost-effectiveness. HTH will advance the scientific understanding of better strategies for CHD prevention among these priority subpopulations and aid in guiding future practice that will reduce health disparities. PMID:17005050

  4. Implementation of ‘matrix support’ (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study

    PubMed Central

    Martins, Sonia Maria; Salibe-Filho, William; Tonioli, Luís Paulo; Pfingesten, Luís Eduardo; Braz, Patrícia Dias; McDonnell, Juliet; Williams, Siân; do Carmo, Débora; de Sousa, Jaime Correia; Pinnock, Hilary; Stelmach, Rafael

    2016-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented ‘matrix support’: a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157–87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems. PMID:27536853

  5. Implementation of 'matrix support' (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study.

    PubMed

    Martins, Sonia Maria; Salibe-Filho, William; Tonioli, Luís Paulo; Pfingesten, Luís Eduardo; Braz, Patrícia Dias; McDonnell, Juliet; Williams, Siân; do Carmo, Débora; de Sousa, Jaime Correia; Pinnock, Hilary; Stelmach, Rafael

    2016-01-01

    Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of hospitalisation and death in the city of Sao Bernardo do Campo. The municipality had difficulties in sustaining a pulmonology specialist team. Local policy has strengthened the knowledge of the primary care teams to improve the management of these diseases. Our aim is to pilot the implementation of an educational intervention based on collaborative care focused on reducing respiratory-related referrals. We implemented 'matrix support': a Brazilian collaborative educational intervention promoting specialist training and support for primary care physicians in three health territories with the highest number of referrals. Clinicians and nurses from primary care attended an 8-h workshop. The backlog of respiratory referrals was prioritised, where Asthma and COPD represented 70% of referral reasons. Initially, pulmonologists held joint consultations with physicians and nurses; as confidence grew, these were replaced by round-table note-based case discussions. The primary outcome was the number of asthma and COPD referrals. Almost all primary healthcare professionals in the three areas (132 of 157-87%) were trained; 360 patients were discussed, including 220 joint consultations. The number of respiratory referrals dropped from 290 (the year before matrix support) to 134 (the year after) (P<0.05). Referrals for asthma/COPD decreased from 13.4 to 5.4 cases per month (P=0.09) and for other lung diseases from 10.8 to 5.3 cases per month (P<0.05). Knowledge scores showed a significant improvement (P<0.001). Matrix-support collaborative care was well-accepted by primary care professionals associated with improved knowledge and reduced respiratory referrals. The initiative attracted specialists to the region overcoming historical recruitment problems. PMID:27536853

  6. Exploring the Effectiveness of an Internet-Based Program for Reducing Caregiver Distress Using the iCare Stress Management e-Training Program

    PubMed Central

    Kajiyama, Bruno; Thompson, Larry W.; Eto-Iwase, Tamiko; Yamashita, Mio; Di Mario, John; Tzuang, Yuan Marian; Gallagher-Thompson, Dolores

    2013-01-01

    OBJECTIVE Determine if the online iCare Stress Management e-Training Program reduces stress, bother depression and poor life quality for dementia family caregivers (CGs). METHOD CGs (N=150) were randomly assigned to the iCare Condition (ICC) or to the Education/Information-Only Condition (EOC) for a 3-month periodChange in self-report measures of stress (PSS) (primary outcome), caregiver bother(RMBPC), depression (CES-D) and quality of life (PQOL) (secondary outcomes) was determined, along with usage of new information in one’s own caregiving. RESULTS A mixed ANOVA revealed that change in perceived stress was significant for the ICC but not the EOC (p = .017). Changes in the other measures were not significant. More caregivers in the ICC used the materials in their own caregiving situation than those in the EOC. Roughly one-third of the caregivers enrolled in the study dropped prior to completion. CONCLUSION Results are promising, but the high dropout is a concern. Future efforts to improve dropout rate and increase participant engagement are warranted. To our knowledge this is the first attempt to present an evidence-based intervention for CGs via the Internet. PMID:23461355

  7. Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis

    PubMed Central

    Goodman, Claire; Rycroft Malone, Jo; Norton, Christine; Harari, Danielle; Harwood, Rowan; Roe, Brenda; Russell, Bridget; Fader, Mandy; Buswell, Marina; Drennan, Vari M; Bunn, Frances

    2015-01-01

    Introduction Faecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high, but it is not an inevitable consequence of old age or dementia. There is good evidence on risk factors, but few studies provide evidence about effective interventions. There is a need to understand how, why, and in what circumstances particular programmes to reduce and manage FI are effective (or not) for people with dementia. The purpose of this review is to identify which (elements of the) interventions could potentially be effective, and examine the barriers and facilitators to the acceptability, uptake and implementation of interventions designed to address FI in people with dementia who are resident in care homes. Methods and analysis A realist synthesis approach to review the evidence will be used which will include studies on continence, person-centred care, implementation research in care homes, workforce and research on care home culture. An iterative four-stage approach is planned. Phase 1: development of an initial programme theory or theories that will be ‘tested’ through a first scoping of the literature and consultation with five stakeholder groups (care home providers, user representatives, academics and practice educators, clinicians with a special interest in FI and continence specialists). Phase 2: a systematic search and analysis of published and unpublished evidence to test and develop the programme theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. Ethics and dissemination The overall protocol does not require ethical review. The University research ethics committee will review interviews conducted as part of phase 1 and 3. The final fourth phase will synthesise and develop recommendations for practice and develop testable hypotheses for further research. PMID:26163032

  8. Towards a no-till no-spray future? Introduction to a symposium on nonchemical weed management for reduced-tillage cropping systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Reduced-tillage systems including no-tillage and strip tillage have well-known benefits for conserving and improving soils, protecting vulnerable crops from extreme weather events, and reducing labor and fuel costs associated with full-width inversion tillage. Despite these benefits, reduced-tillage...

  9. Feasibility of Adapting Multisystemic Therapy to Improve Illness Management Behaviors and Reduce Asthma Morbidity in High Risk African American Youth: A Case Series

    ERIC Educational Resources Information Center

    Naar-King, Sylvie; Ellis, Deborah; Kolmodin, Karen; Cunningham, Phillippe; Secord, Elizabeth

    2009-01-01

    African-American adolescents have the highest rates of asthma morbidity and mortality, yet there are few successful behavioral interventions to improve illness management for this group. Mental health providers have an opportunity to expand their services and impact by targeting adolescents with poor asthma management. We describe the adaptation…

  10. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed Central

    Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

    2002-01-01

    Medical practice today, more than ever before, places greater demands on physicians to see more patients, provide more complex medical services and adhere to stricter regulatory rules, leaving little time for coding and billing. Yet, the need to adequately document medical records, appropriately apply billing codes and accurately charge insurers for medical services is essential to the medical practice's financial condition. Many physicians rely on office staff and billing companies to process their medical bills without ever reviewing the bills before they are submitted for payment. Some physicians may not be receiving the payment they deserve when they do not sufficiently oversee the medical practice's coding and billing patterns. This article emphasizes the importance of monitoring and auditing medical record documentation and coding application as a strategy for achieving compliance and reducing billing errors. When medical bills are submitted with missing and incorrect information, they may result in unpaid claims and loss of revenue to physicians. Addressing Medical Audits, Part I--A Strategy for Achieving Compliance--CMS, JCAHO, NCQA, published January 2002 in the Journal of the National Medical Association, stressed the importance of preparing the medical practice for audits. The article highlighted steps the medical practice can take to prepare for audits and presented examples of guidelines used by regulatory agencies to conduct both medical and financial audits. The Medicare Integrity Program was cited as an example of guidelines used by regulators to identify coding errors during an audit and deny payment to providers when improper billing occurs. For each denied claim, payments owed to the medical practice are are also denied. Health care is, no doubt, a costly endeavor for health care providers, consumers and insurers. The potential risk to physicians for improper billing may include loss of revenue, fraud investigations, financial sanction

  11. Weight, height, and relative-reliability indicators as a management tool for reducing age at first breeding and calving of dairy heifers.

    PubMed

    Duplessis, M; Cue, R I; Santschi, D E; Lefebvre, D M; Lacroix, R

    2015-03-01

    and 747 g/d for HO, 603 and 486 g/d for JE, and 775 and 662 g/d for BS, respectively. These indicators could be calculated for an individual heifer and on a herd-level basis and used on farm as a management tool for reducing age at first breeding and at first calving. PMID:25597973

  12. Manure Management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding of manure management methods and practices from the perspective of pathogen prevalence, survival, and susceptibility to various treatment effects has led to development of several beneficial management practices and technologies for reducing manure pathogens in agricultural landscapes....

  13. Can chronic disease management programs for patients with type 2 diabetes reduce productivity-related indirect costs of the disease? Evidence from a randomized controlled trial.

    PubMed

    Adepoju, Omolola E; Bolin, Jane N; Ohsfeldt, Robert L; Phillips, Charles D; Zhao, Hongwei; Ory, Marcia G; Forjuoh, Samuel N

    2014-04-01

    The objective was to assess the impacts of diabetes self-management programs on productivity-related indirect costs of the disease. Using an employer's perspective, this study estimated the productivity losses associated with: (1) employee absence on the job, (2) diabetes-related disability, (3) employee presence on the job, and (4) early mortality. Data were obtained from electronic medical records and survey responses of 376 adults aged ≥18 years who were enrolled in a randomized controlled trial of type 2 diabetes self-management programs. All study participants had uncontrolled diabetes and were randomized into one of 4 study arms: personal digital assistant (PDA), chronic disease self-management program (CDSMP), combined PDA and CDSMP, and usual care (UC). The human-capital approach was used to estimate lost productivity resulting from 1, 2, 3, and 4 above, which are summed to obtain total productivity loss. Using robust regression, total productivity loss was modeled as a function of the diabetes self-management programs and other identified demographic and clinical characteristics. Compared to subjects in the UC arm, there were no statistically significant differences in productivity losses among persons undergoing any of the 3 diabetes management interventions. Males were associated with higher productivity losses (+$708/year; P<0.001) and persons with greater than high school education were associated with additional productivity losses (+$758/year; P<0.001). Persons with more than 1 comorbid condition were marginally associated with lower productivity losses (-$326/year; P=0.055). No evidence was found that the chronic disease management programs examined in this trial affect indirect productivity losses. PMID:24152055

  14. Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

  15. Evaluating the "Healthy Diabetes" Caribbean Food Plate and Website Portal for Diabetes Prevention and Management: Results of an Online Study and Implications for Reducing Health Disparities

    ERIC Educational Resources Information Center

    Thomas, Nigel M.

    2013-01-01

    Given the challenge of cooking traditional Caribbean meals so they are consistent with the goals of diabetes prevention and management, the researcher created and evaluated a new website portal as e-health tailored to be culturally appropriate and teach the following: how to cook and prepare "Healthy Diabetes" Caribbean Plates. A social…

  16. Managing Multiple Mandates: A System of Systems Model to Analyze Strategies for Producing Cellulosic Ethanol and Reducing Riverine Nitrate Loads in the Upper Mississippi River Basin.

    PubMed

    Housh, Mashor; Yaeger, Mary A; Cai, Ximing; McIsaac, Gregory F; Khanna, Madhu; Sivapalan, Murugesu; Ouyang, Yanfeng; Al-Qadi, Imad; Jain, Atul K

    2015-10-01

    Implementing public policies often involves navigating an array of choices that have economic and environmental consequences that are difficult to quantify due to the complexity of multiple system interactions. Implementing the mandate for cellulosic biofuel production in the Renewable Fuel Standard (RFS) and reducing hypoxia in the northern Gulf of Mexico by reducing riverine nitrate-N loads represent two such cases that overlap in the Mississippi River Basin. To quantify the consequences of these interactions, a system of systems (SoS) model was developed that incorporates interdependencies among the various subsystems, including biofuel refineries, transportation, agriculture, water resources and crop/ethanol markets. The model allows examination of the impact of imposing riverine nitrate-N load limits on the biofuel production system as a whole, including land use change and infrastructure needs. The synergies of crop choice (first versus second generation biofuel crops), infrastructure development, and environmental impacts (streamflow and nitrate-N load) were analyzed to determine the complementarities and trade-offs between environmental protection and biofuel development objectives. For example, the results show that meeting the cellulosic biofuel target in the RFS using Miscanthus x giganteus reduces system profits by 8% and reduces nitrate-N loads by 12% compared to the scenario without a mandate. However, greater water consumption by Miscanthus is likely to reduce streamflow with potentially adverse environmental consequences that need to be considered in future decision making. PMID:26348783

  17. Involvement of a Case Manager in Palliative Care Reduces Hospitalisations at the End of Life in Cancer Patients; A Mortality Follow-Back Study in Primary Care

    PubMed Central

    van der Plas, Annicka G. M.; Vissers, Kris C.; Francke, Anneke L.; Donker, Gé A.; Jansen, Wim J. J.; Deliens, Luc; Onwuteaka-Philipsen, Bregje D.

    2015-01-01

    Background Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal carers in addition to the care provided by the general practitioner (GP) and home-care nurse. Objectives To compare cancer patients with and without additional support from a case manager on: 1) the patients’ general characteristics, 2) characteristics of care and support given by the GP, 3) palliative care outcomes. Methods This article is based on questionnaire data provided by GPs participating in two different studies: the Sentimelc study (280 cancer patients) and the Capalca study (167 cancer patients). The Sentimelc study is a mortality follow-back study amongst a representative sample of GPs that monitors the care provided via GPs to a general population of end-of-life patients. Data from 2011 and 2012 were analysed. The Capalca study is a prospective study investigating the implementation and outcome of the support provided by case managers in primary palliative care. Data were gathered between March 2011 and December 2013. Results The GP is more likely to know the preferred place of death (OR 7.06; CI 3.47-14.36), the place of death is more likely to be at the home (OR 2.16; CI 1.33-3.51) and less likely to be the hospital (OR 0.26; CI 0.13-0.52), and there are fewer hospitalisations in the last 30 days of life (none: OR 1.99; CI 1.12-3.56 and one: OR 0.54; CI 0.30-0.96), when cancer patients receive additional support from a case manager compared with patients receiving the standard GP care. Conclusions Involvement of a case manager has added value in addition to palliative care provided by the GP, even though the role of the case manager is ‘only’ advisory and he or she does not provide hands-on care or prescribe medication. PMID:26208099

  18. Reducing Dropouts.

    ERIC Educational Resources Information Center

    Timpane, Michael; And Others

    A group of three conference papers, all addressing the subject of effective programs to decrease the number of school dropouts, is presented in this document. The first paper, "Systemic Approaches to Reducing Dropouts" (Michael Timpane), asserts that dropping out is a symptom of failures in the social, economic, and educational systems. Dropping…

  19. Double-crested cormorant studies at Little Galloo Island, Lake Ontario in 2008: Diet composition, fish consumption and the efficacy of management activities in reducing fish predation

    USGS Publications Warehouse

    Johnson, James H.; McCullough, Russell D.; Farquhar, James F.

    2008-01-01

    The year 2008 marked the seventeenth consecutive year of study of the food habits and fish consumption of LGI cormorants, and represented the tenth consecutive year evaluating the efficacy of management activities to control the reproductive success of cormorants nesting at LGI. The program consists mainly of spraying cormorant eggs with oil as well as the culling of adult and immature birds.This paper reports the findings of work carried outin 2008 at LGI.

  20. Case Management to Reduce Cardiovascular Disease Risk in American Indians and Alaska Natives With Diabetes: Results From the Special Diabetes Program for Indians Healthy Heart Demonstration Project

    PubMed Central

    Jiang, Luohua; Manson, Spero M.; Beals, Janette; Henderson, William; Pratte, Katherine; Acton, Kelly J.; Roubideaux, Yvette

    2014-01-01

    Objectives. We evaluated cardiovascular disease (CVD) risk factors in American Indians/Alaska Natives (AI/ANs) with diabetes in the Special Diabetes Program for Indians Healthy Heart (SDPI-HH) Demonstration Project. Methods. Multidisciplinary teams implemented an intensive case management intervention among 30 health care programs serving 138 tribes. The project recruited 3373 participants, with and without current CVD, between 2006 and 2009. We examined data collected at baseline and 1 year later to determine whether improvements occurred in CVD risk factors and in Framingham coronary heart disease (CHD) risk scores, aspirin use, and smoking status. Results. A1c levels decreased an average of 0.2% (P < .001). Systolic and diastolic blood pressure, low-density lipoprotein (LDL) cholesterol, and triglyceride levels decreased, with the largest significant reduction in LDL cholesterol (∆ = −5.29 mg/dL; P < .001). Average Framingham CHD risk scores also decreased significantly. Aspirin therapy increased significantly, and smoking decreased. Participants with more case management visits had significantly greater reductions in LDL cholesterol and A1c values. Conclusions. SDPI-HH successfully translated an intensive case management intervention. Creative retention strategies and an improved understanding of organizational challenges are needed for future Indian health translational efforts. PMID:25211728

  1. A Comparison of Computer-Assisted and Self-Management Programs for Reducing Alcohol Use among Students in First Year Experience Courses

    ERIC Educational Resources Information Center

    Lane, David J.; Lindemann, Dana F.; Schmidt, James A.

    2012-01-01

    The National Institute of Alcohol Abuse and Alcoholism has called for the use of evidence-based approaches to address high-risk drinking prevalent on many college campuses. In line with this recommendation, the present study evaluated the efficacy of two evidence-based approaches to reducing alcohol use. One hundred and three college students in…

  2. 4 Rs are not enough: We need 7 Rs for nutrient management and conservation to increase nutrient use efficiency and reduce off-site transport of nutrients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cox (2010) reported that under business as usual, the environmental impacts of nutrient losses from agriculture will not be resolved and that precision conservation and precision regulation are two mechanisms to reduce the environmental impacts of nutrient losses. This is in agreement with the rece...

  3. Managing for resilience

    EPA Science Inventory

    Early efforts in wildlife management focused on reducing population variability and maximizing yields of select species. Aldo Leopold proposed the concept of habitat management as superior to population management. More recently, ecosystem management, whereby ecological processes...

  4. A perspective on re-evaluating digoxin's role in the current management of patients with chronic systolic heart failure: targeting serum concentration to reduce hospitalization and improve safety profile.

    PubMed

    Adams, Kirkwood F; Ghali, Jalal K; Herbert Patterson, J; Stough, Wendy Gattis; Butler, Javed; Bauman, Jerry L; Ventura, Hector O; Sabbah, Hani; Mackowiak, John I; van Veldhuisen, Dirk J

    2014-05-01

    Digoxin improves exercise tolerance and reduces hospitalizations in patients with systolic heart failure, but its use has declined progressively for the past two decades. The Digitalis Investigation Group trial showed that digoxin reduced hospitalizations but had a neutral effect on total mortality. There was evidence that mortality caused by worsening heart failure was less, but there was also a signal suggesting an increase in other cardiac (presumed arrhythmic) death. Use of digoxin has declined substantially and recent guideline recommendations have significantly de-emphasized the importance of this drug in the management of heart failure. Two developments suggest that re-evaluation of the contemporary role of digoxin in the management of heart failure with reduced ejection fraction is warranted. First, heart failure remains progressive, characterized by chronic debility, exercise intolerance, and frequent and costly hospitalizations, despite evidence-based drug and device therapies that prolong survival. Health economics have made reducing hospitalizations in patients with heart failure a major priority. Second, a strong association has emerged between serum concentration and the safety and efficacy of digoxin, which indicates a change in our approach to dosing this agent is needed. Experimental and clinical results suggest that optimizing therapeutic benefit and avoiding harm means dosing to achieve low serum digoxin concentrations (0.5-0.9 ng/mL). Digoxin is an inexpensive agent and the totality of evidence indicates that it reduces hospitalizations and improves symptoms safely when dosed to achieve low serum concentrations. These findings suggest digoxin should have a more prominent therapeutic role in patients with heart failure and reduced ejection fraction. PMID:24574198

  5. Identifying Advanced Glycation End Products as a Major Source of Oxidants in Aging: Implications for the Management and/or Prevention of Reduced Renal Function in Elderly Persons

    PubMed Central

    Vlassara, Helen; Uribarri, Jaime; Ferrucci, Luigi; Cai, Weijing; Torreggiani, Massimo; Post, James B.; Zheng, Feng; Striker, Gary E.

    2016-01-01

    Summary Aging is characterized by increasing inflammation and oxidant stress (OS). Reduced renal function was present in more than 20% of normal-aged individuals sampled in the National Health and Nutrition Examination Survey (NHANES) cross-sectional study of the US population. Longitudinal studies in the United States and Italy showed that renal function does not decline in some individuals, suggesting that a search for causes of the loss of renal function in some persons might be indicated and interventions to reduce this outcome should be sought. Because advanced glycation end products (AGEs) induce both inflammation and OS, accumulate with age, and primarily are excreted by the kidney, one outcome of reduced renal function in aging could be decreased AGE disposal. The build-up of AGEs with reduced renal function could contribute to inflammation, increased oxidant stress, and accumulation of AGEs in aging. In fact, results from a longitudinal study of normal aging adults in Italy showed that the most significant correlation with mortality was the level of renal function. A clear link between inflammation, OS, AGEs, and chronic disease was shown in studies of mice that showed that reduction of AGE levels by drugs or decreased intake of AGEs reduces chronic kidney disease (CKD) and cardiovascular disease of aging. The data support a role for AGEs in the development of renal lesions in aging mice and reveal that AGEs in the diet are very important contributors to renal and cardiovascular lesions. AGEs signal through two receptors, one of which is anti-inflammatory (AGER1) and the other is proinflammatory (RAGE). Overexpression of AGER1 protects against OS and acute vascular injury. The reduction of AGEs in the diet is as efficient in preventing aging-related cardiovascular and renal lesions in mice as that seen with calorie restriction. Studies in normal adults of all ages and those with CKD suggest that the findings in mice may be directly applicable to both aging

  6. Reduced acute toxicity and improved efficacy from intensity-modulated proton therapy (IMPT) for the management of head and neck cancer.

    PubMed

    McKeever, Matthew R; Sio, Terence T; Gunn, G Brandon; Holliday, Emma B; Blanchard, Pierre; Kies, Merrill S; Weber, Randal S; Frank, Steven J

    2016-08-01

    Cancers in the head and neck area are usually close to several critical organ structures. Traditional external-beam photon radiation therapy unavoidably exposes these structures to significant doses of radiation, which can lead to serious acute and chronic toxicity. Intensity-modulated proton therapy (IMPT), however, has dosimetric advantages that allow it to deposit high doses within the target while largely sparing surrounding structures. Because of this advantage, IMPT has the potential to improve both tumor control and toxicity. To determine the degree to which IMPT can reduce toxicity and improve tumor control, more randomized trials are needed that directly compare IMPT with intensity-modulated photon therapy. Here we examine the existing evidence on the efficacy and toxicity of IMPT for treating cancers at several anatomic subsites of the head and neck. We also report on the ability of IMPT to reduce malnutrition, and gastrostomy tube dependence and improve patient-reported outcomes (PROs). PMID:27506808

  7. Risk Management.

    ERIC Educational Resources Information Center

    Randal, L. Nathan

    This chapter of "Principles of School Business Management" presents an overview of risk management for school districts. The chapter first discusses four fundamental elements of risk management: (1) identifying and measuring risks; (2) reducing or eliminating risks; (3) transferring unassumable risks; and (4) assuming remaining risks. The chapter…

  8. IMPROVING ENERGY EFFICIENCY AND REDUCING COSTS IN THE DRINKING WATER SUPPLY INDUSTRY: An ENERGY STAR Resource Guide for Energy and Plant Managers

    SciTech Connect

    Melody, Moya; Dunham Whitehead, Camilla; Brown, Richard

    2010-09-30

    As American drinking water agencies face higher production costs, demand, and energy prices, they seek opportunities to reduce costs without negatively affecting the quality of the water they deliver. This guide describes resources for cost-effectively improving the energy efficiency of U.S. public drinking water facilities. The guide (1) describes areas of opportunity for improving energy efficiency in drinking water facilities; (2) provides detailed descriptions of resources to consult for each area of opportunity; (3) offers supplementary suggestions and information for the area; and (4) presents illustrative case studies, including analysis of cost-effectiveness.

  9. Prophylactic use of tranexamic acid combined with thrombelastogram guided coagulation management may reduce blood loss and allogeneic transfusion in pediatric hemispherectomy: case series.

    PubMed

    Xiao, Wei; Fu, Wenya; Wang, Tianlong; Zhao, Lei

    2016-09-01

    Hemispherectomy is an established surgical procedure to treat medically refractory epilepsy caused by diffuse hemispheric diseases. The most common complication of hemispherectomy is intraoperative bleeding. Perioperative allogeneic blood transfusion increases mortality and morbidity in pediatric patients. Etiologies of massive blood loss during hemispherectomy include intraoperative diffuse vascular damage, antileptic drugs induced coagulation dysfunction, hyperfibrinolysis and dilutional coagulopathy. Great efforts should be made to minimize the need of blood transfusion. We present a series of three cases undergoing pediatric hemispherectomy, where a new algorithm was employed to manage coagulation. This new algorithm was mainly based on timely thrombelastogram analyses guided clotting factors supplement and continuous administration of tranexamic acid. In our cases, the amount of blood loss and subsequent allogeneic blood transfusion seemed to be less than literature reported. PMID:27555151

  10. ISS Update: Reduced Gravity Education

    NASA Video Gallery

    NASA Public Affairs Officer Dan Huot interviews Veronica Seyl, Acting Manager for Reduced Gravity Education. NASA works with students and educators to design experiments for flight testing aboard t...

  11. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out

    PubMed Central

    Stoyanov, Drozdstoj S.; Cloninger, C. Robert

    2013-01-01

    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the ‘burn-out’ syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed ‘flame-out’. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and

  12. Efforts to Reduce International Space Station Crew Maintenance Time in the Management of the Extravehicular Mobility Unit Transport Loop Water Quality

    NASA Technical Reports Server (NTRS)

    Etter,David; Rector, Tony; Boyle, robert; Zande, Chris Vande

    2012-01-01

    The EMU (Extravehicular Mobility Unit) contains a semi-closed-loop re-circulating water circuit (Transport Loop) to absorb heat into a LCVG (Liquid Coolant and Ventilation Garment) worn by the astronaut. A second, single-pass water circuit (Feed-water Loop) provides water to a cooling device (Sublimator) containing porous plates, and that water sublimates through the porous plates to space vacuum. The cooling effect from the sublimation of this water translates to a cooling of the LCVG water that circulates through the Sublimator. The quality of the EMU Transport Loop water is maintained through the use of a water processing kit (ALCLR - Airlock Cooling Loop Remediation) that is used to periodically clean and disinfect the water circuit. Opportunities to reduce crew time associated with ALCLR operations include a detailed review of the historical water quality data for evidence to support an extension to the implementation cycle. Furthermore, an EMU returned after 2-years of use on the ISS (International Space Station) is being used as a test bed to evaluate the results of extended and repeated ALCLR implementation cycles. Finally, design, use and on-orbit location enhancements to the ALCLR kit components are being considered to allow the implementation cycle to occur in parallel with other EMU maintenance and check-out activities, and to extend the life of the ALCLR kit components. These efforts are undertaken to reduce the crew-time and logistics burdens for the EMU, while ensuring the long-term health of the EMU water circuits for a post- Shuttle 6-year service life.

  13. Reduced Fluorescein Angiography and Fundus Photography Use in the Management of Neovascular Macular Degeneration and Macular Edema During the Past Decade

    PubMed Central

    Schneider, Eric W.; Mruthyunjaya, Prithvi; Talwar, Nidhi; Harris Nwanyanwu, Kristen; Nan, Bin; Stein, Joshua D.

    2014-01-01

    Purpose. We assessed recent trends in the use of diagnostic testing for neovascular age-related macular degeneration (NVAMD) and macular edema (ME). Methods. Claims data from a managed-care network were analyzed on patients with NVAMD (n = 22,954) or ME (n = 31,810) to assess the use of fluorescein angiography (FA), fundus photography (FP), and optical coherence tomography (OCT) from 2001 to 2009. Repeated-measures logistic regression was performed to compare patients' odds of undergoing these procedures in 2001, 2005, and 2009. In addition, the proportions of patients with an incident NVAMD or ME diagnosis in 2003 or 2008 who underwent FA, FP, and OCT were compared. Results. From 2001 to 2009, among patients with NVAMD, the odds of undergoing OCT increased 23-fold, whereas the odds of receiving FA and FP decreased by 68% and 79%, respectively. Similar trends were observed for ME. From 2003 to 2008, the proportion of patients undergoing OCT within 1 year of initial diagnosis increased by 315% for NVAMD and by 143% for ME; the proportion undergoing OCT without FA within 1 year increased by 463% for NVAMD and by 216% for ME. Conclusions. Use of OCT increased dramatically during the past decade, whereas use of FA and FP declined considerably, suggesting that OCT may be replacing more traditional diagnostic testing in patients with NVAMD or ME. Future studies should evaluate whether this increased reliance on OCT instead of FA and FP affects patient outcomes. PMID:24346174

  14. Can mercury in fish be reduced by water level management? Evaluating the effects of water level fluctuation on mercury accumulation in yellow perch (Perca flavescens)

    USGS Publications Warehouse

    Larson, James H.; Maki, Ryan P.; Knights, Brent C.; Gray, Brian R.

    2014-01-01

    Mercury (Hg) contamination of fisheries is a major concern for resource managers of many temperate lakes. Anthropogenic Hg contamination is largely derived from atmospheric deposition within a lake’s watershed, but its incorporation into the food web is facilitated by bacterial activity in sediments. Temporal variation in Hg content of fish (young-of-year yellow perch) in the regulated lakes of the Rainy–Namakan complex (on the border of the United States and Canada) has been linked to water level (WL) fluctuations, presumably through variation in sediment inundation. As a result, Hg contamination of fish has been linked to international regulations of WL fluctuation. Here we assess the relationship between WL fluctuations and fish Hg content using a 10-year dataset covering six lakes. Within-year WL rise did not appear in strongly supported models of fish Hg, but year-to-year variation in maximum water levels (∆maxWL) was positively associated with fish Hg content. This WL effect varied in magnitude among lakes: In Crane Lake, a 1 m increase in ∆maxWL from the previous year was associated with a 108 ng increase in fish Hg content (per gram wet weight), while the same WL change in Kabetogama was associated with only a 5 ng increase in fish Hg content. In half the lakes sampled here, effect sizes could not be distinguished from zero. Given the persistent and wide-ranging extent of Hg contamination and the large number of regulated waterways, future research is needed to identify the conditions in which WL fluctuations influence fish Hg content.

  15. Managing Restored Wetlands in the Sacramento-San Joaquin Delta to Reduce Methane Emissions and Increase Carbon Uptake Laurie Koteen, Sara Knox, Cove Sturtevant, Joseph Verfaillie, Jaclyn Hatala, Dennis Baldocchi

    NASA Astrophysics Data System (ADS)

    Koteen, L. E.; Knox, S. H.; Sturtevant, C. S.; Verfaillie, J. G.; Matthes, J. H.; Baldocchi, D. D.

    2013-12-01

    The Sacramento-San Joaquin Delta of California is a region transformed by more than a century of agricultural practices. Beginning in the 19th century, substantial regions were first drained of water and then converted to cropland in order to take advantage of the area's rich peatland soils. In the intervening time period, soil oxidation and subsidence have led to huge peat losses of up to 10 m in some places, and river water now threatens to topple the levees that were erected to keep fields from flooding. Within this region, we have been monitoring greenhouse gas exchange of several agricultural sites, a degraded pasture, and two restored wetlands. Of these land use types, restoration of wetlands is of particular interest to Delta managers as these sites attain many of the region's most pressing ecological goals, including improved water quality, increased wildlife habitat, and soil accretion. In our current investigation, we hope to assess if wetland management activities can be implemented to achieve greenhouse gas management goals as well. While we find that the restored wetlands are able to take up and store a substantial amount of carbon via rapid growth rates, they also emit methane; a greenhouse gas 25 times more potent than CO¬2. We are currently in the process of implementing two management activities with the goals of reducing methane emissions and increasing carbon uptake. Evidence from the wetland literature indicates that periodic lowering of the water table below the soil surface can reduce wetland methane emissions by: 1. Reintroducing oxygen into the soil column. This both supports growth of the methanotrophic bacteria that consume methane produced in the anaerobic zones of the soil column, and suppresses the methanogens that produce it. 2. Re-oxidization of formerly reduced compounds in the soil, (i.e. NO3-, SO42-) which can serve as alternative terminal electron acceptors of the decomposition byproducts (i.e. H2 and acetate) that lead to

  16. Reducing the Teacher Workforce: A Management Perspective.

    ERIC Educational Resources Information Center

    Collins, Philip; Nelson, Dorothy Q.

    1983-01-01

    Discusses substantive and procedural restraints, including legal pitfalls, due process, and no-layoff clauses, within which public employers must decide questions of reduction in workforce (RIF). Describes elements of a sound RIF policy and considers ways of using the collective bargaining process to facilitate the RIF process. (JBM)

  17. Managing biogeochemical cycles to reduce greenhouse gases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This special issue focuses on terrestrial biogeochemical cycles and their roles in determining current continental-scale budgets and future trends in biogenic greenhouse gases (GHGs) for North America. Understanding the current magnitude and forecasting future trajectories of atmospheric GHG concent...

  18. MANAGEMENT STRATEGIES TO REDUCE EMBRYONIC LOSS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mechanisms involved in pregnancy establishment and maintenance in cattle are complex. Approximately 95% of matings, regardless of whether they are by artificial insemination or natural service, result in fertilization. However, rarely do 70% of these matings result in a pregnancy that is maintaine...

  19. Hydrology and the hypothetical effects of reducing nutrient applications of water quality in the Bald Eagle Creek Headwaters, southeastern Pennsylvania prior to implementation of agricultural best-management practices

    USGS Publications Warehouse

    Fishel, D.K.; Langland, M.J.; Truhlar, M.V.

    1991-01-01

    The report characterizes a 0.43-square-mile agricultural watershed in York County, underlain by albite-chlorite and oligoclase-mica schist in the Lower Susquehanna River basin, that is being studied as part of the U.S. Environmental Protection Agency's Chesapeake Bay Program. The water quality of Bald Eagle Creek was studied from October 1985 through September 1987 prior to the implementation of Best-Management Practices to reduce nutrient and sediment discharge into Muddy Creek, a tributary to the Chesapeake Bay. About 88 percent of the watershed is cropland and pasture, and nearly 33 percent of the cropland is used for corn. The animal population is entirely dairy cattle. About 85,640 pounds of nitrogen (460 pounds per acre) and 21,800 pounds of phosphorus (117 pounds per acre) were applied to fields; 52 percent of the nitrogen and 69 percent of the phosphorus was from commercial fertilizer. Prior to fertilization, nitrate nitrogen in the soil ranged from 36 to 136 pounds per acre and phosphorus ranged from 0.89 to 5.7 pounds per acre in the top 4 feet of soil. Precipitation was about 18 percent below normal and streamflow about 35 percent below normal during the 2-year study. Eighty-four percent of the 20.44 inches of runoff was base flow. Median concentrations of total nitrogen and dissolved phosphorous in base flow were 0.05 and 0.04 milligrams per liter as phosphorus, respectively. Concentrations of dissolved nitrate in base flow increased following wet periods after crops were harvested and manure was applied. During the growing season, concentrations decreased similarly to those observed in carbonate-rock areas as nutrient uptake and evapotranspiration by corn increased. About 4,550 pounds of suspended sediment, 5,250 pounds of nitrogen, and 66.6 pounds of phosphorus discharged in base flow during the 2-year period. The suspended sediment load was about 232,000 pounds in stormflow from 26 storms that contributed 51 percent of the total stormflow. The

  20. Total Water Management

    EPA Science Inventory

    This project will investigate total water management (TWM) as a way of improving water resource management and reducing waste streams. This project will also improve management of potable water, wastewater and wet-weather flow through combined management, reuse and recycling wil...

  1. Injection-Related Venous Disease and Walking Mobility

    PubMed Central

    Pieper, Barbara; Templin, Thomas N.; Kirsner, Robert S.; Birk, Thomas J.

    2010-01-01

    Injection users are at risk for vascular injuries resulting in chronic venous disease (CVD). We examined walking mobility in relation to CVD for 713 persons in methadone treatment. We used a cross-sectional, comparative design, stratified on age, sex, ethnicity, and drug use. CVD was present in 92.3% of participants. The structural equation model supported the causal link between leg injection and CVD (.40, P<.001). The worse the mobility, the greater was the CVD classification (-.21, P<.001). CVD had an indirect effect on mobility through pain. CVD and pain need to be considered when assessing mobility in illicit drug users. PMID:20924885

  2. Machines that Manage.

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2003-01-01

    Describes how facilities-management systems use technology to help schools and universities operate their buildings more efficiently, reduce energy consumption, manage inventory more accurately, keep track of supplies and maintenance schedules, and save money. (EV)

  3. Exemplary Management Techniques

    ERIC Educational Resources Information Center

    School Business Affairs, 1977

    1977-01-01

    Featured in the third article of the series are management techniques for school insurance record management and for reducing the amount of time school maintenance personnel spend driving from school to school. (Author/MLF)

  4. Total Water Management - slides

    EPA Science Inventory

    Total Water Management (TWM) examines urban water systems in an interconnected manner. It encompasses reducing water demands, increasing water recycling and reuse, creating water supply assets from stormwater management, matching water quality to end-use needs, and achieving envi...

  5. Disease management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soilborne pathogens that cause root diseases spend most of their life cycle in or on the soil. Soil management decisions will influence the survival, growth of these pathogens and severity of disease. Many of the cultural methods that growers have relied on in the past to reduce the impact of the...

  6. The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011.

    PubMed

    Ray, Kausik K; Kastelein, John J P; Boekholdt, S Matthijs; Nicholls, Stephen J; Khaw, Kay-Tee; Ballantyne, Christie M; Catapano, Alberico L; Reiner, Željko; Lüscher, Thomas F

    2014-04-01

    Atherosclerotic cardiovascular disease is the most important public health problem of our time in both Europe and the rest of the world, accounting for the greatest expenditure in most healthcare budgets. Achieving consistency of clinical care, incorporating new evidence and their synthesis into practical recommendations for clinicians is the task of various guideline committees throughout the world. Any change in a set of guidelines therefore can have far reaching consequences, particularly if they appear to be at variance with the existing guidelines. The present article discusses the recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines 2013 on the control of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults. When compared with the ESC/EAS guidelines on lipid modification in 2011, the ACC/AHA guidelines of 2013 differ markedly. Specifically, (i) the scope is limited to randomized trials only, which excludes a significant body of data and promotes essentially a statin centric approach only; (ii) the abolition of low-density lipoprotein cholesterol (LDL-C) targets in favour of specific statin regimens that produce a 30-50% reduction in LDL-C we believe will confuse many physicians and miss the opportunity for medication adherence and patient engagement in self-management; (iii) the absence of target LDL-C levels in very high-risk patients with high absolute risk or residual risk factors will discourage clinicians to consider the addition of lipid modification treatments and individualize patient care; (iv) a reduction in the threshold for treatment in primary prevention will result in a greater number of patients being prescribed statin therapy, which is potentially good in young patients with high life time risk, but will result in a very large number of older patients offered therapy; and (v) the mixed pool risk calculator used to asses CVD risk in the guidelines for primary prevention has not

  7. Risk management.

    PubMed

    Chambers, David W

    2010-01-01

    Every plan contains risk. To proceed without planning some means of managing that risk is to court failure. The basic logic of risk is explained. It consists in identifying a threshold where some corrective action is necessary, the probability of exceeding that threshold, and the attendant cost should the undesired outcome occur. This is the probable cost of failure. Various risk categories in dentistry are identified, including lack of liquidity; poor quality; equipment or procedure failures; employee slips; competitive environments; new regulations; unreliable suppliers, partners, and patients; and threats to one's reputation. It is prudent to make investments in risk management to the extent that the cost of managing the risk is less than the probable loss due to risk failure and when risk management strategies can be matched to type of risk. Four risk management strategies are discussed: insurance, reducing the probability of failure, reducing the costs of failure, and learning. A risk management accounting of the financial meltdown of October 2008 is provided. PMID:21314051

  8. Methods To Reduce Soil Fumigation Emissions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil fumigation is an important management practice for controlling soil pests in many high value crops including almonds. Reducing atmospheric emissions is necessary to minimize the environmental impact of soil fumigation. Water seals (sprinkling water on soil surface) to reduce fumigant emissions...

  9. Reduce HIV Risk

    MedlinePlus

    ... incidence could be reduced if people changed their sexual behaviors. Our research has demonstrated remarkable success in reducing HIV risk-associated sexual behaviors among African American adolescents and adults." Spring 2008 ...

  10. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life.

    PubMed

    Rod, Kevin

    2016-01-01

    Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management. Design. Observational study. Subjects. Two hundred (200) patients (61% females, 39% males, between 18 and 75 years old) from one community pain clinic in Toronto, Canada (Toronto Poly Clinic), participated. Patients had moderate to severe pain, depression, and anxiety. These patients committed to study from a group of 515 patients with chronic noncancer pain of different origins who were stable on their levels of pain, anxiety, and depression for 12 consecutive months before start of study and could not afford noninsured treatment modalities like physiotherapy, psychology, nutrition, or exercise therapy consultation. Methods. Patients were encouraged to visit two Internet sites (a blog and Twitter postings) for educational postings written by the author about exercise, nutrition, mindfulness meditation, disease management methods, evidence-based supplements, daily relaxation exercises, and overall self-management methods 15 minutes per day for six months. Patients were also encouraged to share their ideas and comments on a blog. Activity logs were kept by patients and reviewed by physician at follow-up visits. Compliance was encouraged via weekly email reminders and phone calls during the observation period. Results. Modest improvements were noted in pain, anxiety, depression, and quality of life. Of the patients with moderate or severe pain before treatment, 45% reported mild levels of pain after treatment

  11. Finding Ways to Lift Barriers to Care for Chronic Pain Patients: Outcomes of Using Internet-Based Self-Management Activities to Reduce Pain and Improve Quality of Life

    PubMed Central

    Rod, Kevin

    2016-01-01

    Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management. Design. Observational study. Subjects. Two hundred (200) patients (61% females, 39% males, between 18 and 75 years old) from one community pain clinic in Toronto, Canada (Toronto Poly Clinic), participated. Patients had moderate to severe pain, depression, and anxiety. These patients committed to study from a group of 515 patients with chronic noncancer pain of different origins who were stable on their levels of pain, anxiety, and depression for 12 consecutive months before start of study and could not afford noninsured treatment modalities like physiotherapy, psychology, nutrition, or exercise therapy consultation. Methods. Patients were encouraged to visit two Internet sites (a blog and Twitter postings) for educational postings written by the author about exercise, nutrition, mindfulness meditation, disease management methods, evidence-based supplements, daily relaxation exercises, and overall self-management methods 15 minutes per day for six months. Patients were also encouraged to share their ideas and comments on a blog. Activity logs were kept by patients and reviewed by physician at follow-up visits. Compliance was encouraged via weekly email reminders and phone calls during the observation period. Results. Modest improvements were noted in pain, anxiety, depression, and quality of life. Of the patients with moderate or severe pain before treatment, 45% reported mild levels of pain after treatment

  12. Reducing rattlesnake-human conflicts

    USGS Publications Warehouse

    Nowak, Erika M.

    2006-01-01

    Arizona is home to 11 species of rattlesnakes. As rapidly growing Arizona communities move into formerly undeveloped landscapes, encounters between people and rattlesnakes increase. As a result, the management of nuisance snakes, or snakes found in areas where people do not want them, is increasingly important. Since 1994, the U.S. Geological Survey (USGS) has conducted research on the behavior and ecology of nuisance rattlesnake in Arizona national park units. A decade of research provides important insights into rattlesnake behavior that can be used by national parks and communities to reduce rattlesnake-human conflicts.

  13. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promot...

  14. Reducing Rock Climbing Risks.

    ERIC Educational Resources Information Center

    Attarian, Aram

    1998-01-01

    Provides checklists that can be used as risk-management tools to evaluate rock-climbing programs: developing goals, policies, and procedures; inspecting the climbing environment; maintaining and inspecting equipment; protecting participants; and managing staff (hiring, training, retraining, and evaluating) and campers (experience level, needs, and…

  15. Managing diversity.

    PubMed

    Wagner, M

    1991-09-30

    One look at projections for the U.S. work force through the year 2000 shows why healthcare administrators will be facing some new challenges. With the majority of new workers belonging to minority groups, "managing diversity" has become the newest catch phrase as executives work to reduce tensions resulting from race, gender or culture-based differences among workers, while also learning to understand and value those differences. PMID:10114151

  16. Managing Change

    PubMed Central

    Lorenzi, Nancy M.; Riley, Robert T.

    2000-01-01

    As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a “technically best” system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change—including to new technologies—to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas—why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics. PMID:10730594

  17. Hazmat review reduces risk and improves operations

    SciTech Connect

    Hartley, P.W.; Trecha, S.J.; Patterson, P.

    1996-07-01

    Through its hazardous materials (hazmat) review initiative, Wisconsin Power and Light Co. (WP and L) repositioned itself for better plant operations while reducing the overall risks and costs associated with hazmats. The utility focused on two primary hazmat improvement objectives: (1) ensure plant hazmat operations are meeting regulatory requirements, optimizing the use, storage, and disposal of hazmats; (2) reduce the overall risk and investment associated with hazmat substances on the plant properties. ``Hazardous materials management is often overlooked as an integral component of the overall purchasing and materials management process``, emphasized Jill Doucette, WP and L Strategic Sourcing Initiative manager. ``Improved performance in this area can significantly reduce personnel and company risks, improve customer service and save dollars.``

  18. 4 R’s are not enough: We need 7 R’s for nutrient management and conservation to increase nutrient use efficiency and reduce off-site transport of nutrients

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cox (2010) reported that under business as usual, the environmental impacts of nutrient losses from agriculture will not be resolved and that precision conservation and precision regulation are two mechanisms to reduce the environmental impacts of nutrient losses. This is in agreement with the rece...

  19. Reducing admissions with patient group directions.

    PubMed

    Wat, Dennis; Glossage, Elaine; Hampson, Onnor; Sibley, Sarah

    In times of financial restrictions and reform impediments, health services need to invest in resources that provide value for money and reduce hospital admissions. Improving disease management in the community is a primary target for those trying to reduce costs. The second most common cause of emergency admissions to hospital is chronic obstructive pulmonary disease and it has been suggested that more effective treatments and better management of the condition would likely result in an estimated 5% fewer admissions to hospital, saving around pound 15.5m each year. This article discusses how savings could be made by improving care provided in the community. PMID:24834601

  20. Vanadium Nitrogenase Reduces CO*

    PubMed Central

    Lee, Chi Chung; Hu, Yilin; Ribbe, Markus W.

    2011-01-01

    Vanadium nitrogenase not only reduces dinitrogen to ammonia but also reduces carbon monoxide to ethylene, ethane, and propane. The parallelism between the two reactions suggests a potential link in mechanism and evolution between the carbon and nitrogen cycles on Earth. PMID:20689010

  1. Vanadium nitrogenase reduces CO.

    PubMed

    Lee, Chi Chung; Hu, Yilin; Ribbe, Markus W

    2010-08-01

    Vanadium nitrogenase not only reduces dinitrogen to ammonia but also reduces carbon monoxide to ethylene, ethane, and propane. The parallelism between the two reactions suggests a potential link in mechanism and evolution between the carbon and nitrogen cycles on Earth. PMID:20689010

  2. Reducible oxide based catalysts

    DOEpatents

    Thompson, Levi T.; Kim, Chang Hwan; Bej, Shyamal K.

    2010-04-06

    A catalyst is disclosed herein. The catalyst includes a reducible oxide support and at least one noble metal fixed on the reducible oxide support. The noble metal(s) is loaded on the support at a substantially constant temperature and pH.

  3. Reducing Teacher Incompetence.

    ERIC Educational Resources Information Center

    Rich, John Martin

    1988-01-01

    Suggests how administrators may reduce teacher incompetence. Teacher incompetence can be reduced if administrators fully understand and undertake appropriate preventive and remedial measures. Two sections comprise this article. First, a taxonomy of teacher incompetence reveals the magnitude of the problem. Second, preventive and remedial measures…

  4. Boiler burden reduced at Bedford site.

    PubMed

    Horsley, Chris

    2011-10-01

    With the NHS aiming to reduce its 2007 carbon footprint by 10% by 2015, Chris Horsley, managing director of Babcock Wanson UK, a provider of industrial boilers and burners, thermal oxidisers, air treatment, water treatment, and associated services, looks at how one NHS Trust has approached the challenge, and considerably reduced its carbon emissions, by refurbishing its boiler house and moving from oil to gas-fired steam generation. PMID:22049674

  5. Reducing Childhood Obesity

    MedlinePlus

    ... Bar Home Current Issue Past Issues Reducing Childhood Obesity Past Issues / Summer 2007 Table of Contents For ... Ga. were the first three We Can! cities. Obesity Research: A New Approach The percentage of children ...

  6. Reduced Extended MHD

    NASA Astrophysics Data System (ADS)

    Morrison, P. J.; Abdelhamid, H. M.; Grasso, D.; Hazeltine, R. D.; Lingam, M.; Tassi, E.

    2015-11-01

    Over the years various reduced fluid models have been obtained for modeling plasmas, with the goal of capturing important physics while maintaining computability. Such models have included the physics contained in various generalizations of Ohm's law, including Hall drift and electron inertia. In a recent publication it was shown that full 3D extended MHD is a Hamiltonian system by finding its noncanonical Poisson bracket. Subsequently, this bracket was shown to be derivable from that for Hall MHD by a series of remarkable transformations, which greatly simplifies the proof of the Jacobi identity and allows one to immediately obtain generalizations of the helicity and cross helicity. In this poster we use this structure to obtain exact reduced fluid models with the effects of full two-fluid theory. Results of numerical computations of collisionless reconnection using an exact reduced 4-field model will be presented and analytical comparisons of mode structure of previous reduced models will be made.

  7. REDUCED PROTECTIVE CLOTHING DETERMINATIONS

    SciTech Connect

    BROWN, R.L.

    2003-06-13

    This technical basis document defines conditions where reduced protective clothing can be allowed, defines reduced protective clothing, and documents the regulatory review that determines the process is compliant with the Tank Farm Radiological Control Manual (TFRCM) and Title 10, Part 835, of the Code of Federal Regulations (10CFR835). The criteria, standards, and requirements contained in this document apply only to Tank Farm Contractor (TFC) facilities.

  8. Reduced shear power spectrum

    SciTech Connect

    Dodelson, Scott; Shapiro, Charles; White, Martin J.; /UC, Berkeley, Astron. Dept. /UC, Berkeley

    2005-08-01

    Measurements of ellipticities of background galaxies are sensitive to the reduced shear, the cosmic shear divided by (1-{kappa}) where {kappa} is the projected density field. They compute the difference between shear and reduced shear both analytically and with simulations. The difference becomes more important an smaller scales, and will impact cosmological parameter estimation from upcoming experiments. A simple recipe is presented to carry out the required correction.

  9. Strategy Reduces Construction Costs.

    ERIC Educational Resources Information Center

    Flynn, Jim; Petters, Walt

    2000-01-01

    Reveals how a Florida school district had success when switching from a design-bid-build approach for school construction to a construction management (CM) at risk. The CM at risk process involving project delivery options, maximum price guarantees, and the school district's benefits in cost savings accrued are addressed. (GR)

  10. Scientist Researches Way to Reduce Global Warming

    Technology Transfer Automated Retrieval System (TEKTRAN)

    For the last four years, scientists at the USDA, Agricultural Research Service, Northern Plains Agricultural Research Laboratory have been searching for alternative soil and crop management practices to reduce greenhouse gas emissions and increase carbon and nitrogen sequestration. “If we can redu...

  11. Reducing pharmacy costs through improved utilization.

    PubMed

    Bates, Cinda; Richards, Barton S

    2013-06-01

    Strategies Trinity Regional Health System in Rock Island, III., used to reduce pharmacy expenses included: Leveraging benchmarking information to identify opportunities for cost savings. Implementing change management techniques, bolstered by well-presented and coherent data, to promote acceptance of change. Forming a multidisciplinary team of clinical and financial leaders to address quality, outcomes, and cost issues and collaborate on solutions. PMID:23795386

  12. Sodium Valproate Withdrawal Correlates with Reduced Aggression

    ERIC Educational Resources Information Center

    Pritchard, Duncan; Hoerger, Marguerite; Dyer, Tim; Graham, Nicola; Penney, Heather; Mace, F. Charles

    2014-01-01

    People with learning disabilities are sometimes prescribed psychotropic medication to help manage their challenging behaviour. This case study describes how a multicomponent behavioural intervention in conjunction with the systematic withdrawal of sodium valproate was strongly correlated with reduced aggression. No symptoms of bipolar disorder or…

  13. How to reduce your fire insurance rates

    NASA Technical Reports Server (NTRS)

    Dubain, M.

    1971-01-01

    Construction procedures and utilization of materials to reduce the cost of insuring large buildings against losses from fire are discussed. Examples of good and bad techniques in building construction and fire safety management are provided. The inadequacies of building codes and the hazards resulting from improper construction are examined.

  14. The Three Rs: Reduce, Reuse, Recycle.

    ERIC Educational Resources Information Center

    Science Activities, 1991

    1991-01-01

    A student hand-out for a recycling unit defines the terms reduce, recycle, and reuse as they relate to solid waste management. Presents the characteristics of recyclable items such as yard wastes, metals, glass, and paper. Lists organizations through which more information about recycling can be obtained. (MCO)

  15. Managing hypoglycaemia.

    PubMed

    Iqbal, Ahmed; Heller, Simon

    2016-06-01

    Intensive glycaemic control reduces the diabetic microvascular disease burden but iatrogenic hypoglycaemia is a major barrier preventing tight glycaemic control because of the limitations of subcutaneous insulin preparations and insulin secretagogues. Severe hypoglycaemia is uncommon early in the disease as robust physiological defences, particularly glucagon and adrenaline release, limit falls in blood glucose whilst associated autonomic symptoms drive patients to take action by ingesting oral carbohydrate. With increasing diabetes duration, glucagon release is progressively impaired and sympatho-adrenal responses are activated at lower glucose levels. Repeated hypoglycaemic episodes contribute to impaired defences, increasing the risk of severe hypoglycaemia in a vicious downward spiral. Managing hypoglycaemia requires a systematic clinical approach with structured insulin self-management training and support of experienced diabetes educators. Judicious use of technologies includes insulin analogues, insulin pump therapy, continuous glucose monitoring, and in a few cases islet cell transplantation. Some individuals require specialist psychological support. PMID:27432075

  16. Weed Management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Adaptive management can complement integrated programs to manage weeds in forage production systems. This approach requires establishing management goals, developing and implementing management programs based on the goals, monitoring and assessing impacts of management efforts, and modifying goals a...

  17. Tank closure reducing grout

    SciTech Connect

    Caldwell, T.B.

    1997-04-18

    A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr{sup 90}, the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel.

  18. Reduced Vector Preisach Model

    NASA Technical Reports Server (NTRS)

    Patel, Umesh D.; Torre, Edward Della; Day, John H. (Technical Monitor)

    2002-01-01

    A new vector Preisach model, called the Reduced Vector Preisach model (RVPM), was developed for fast computations. This model, derived from the Simplified Vector Preisach model (SVPM), has individual components that like the SVPM are calculated independently using coupled selection rules for the state vector computation. However, the RVPM does not require the rotational correction. Therefore, it provides a practical alternative for computing the magnetic susceptibility using a differential approach. A vector version, using the framework of the DOK model, is implemented. Simulation results for the reduced vector Preisach model are also presented.

  19. Computerized Data Management.

    ERIC Educational Resources Information Center

    Grzywinski, Carol M.

    1983-01-01

    Argues that a computerized data management system can help the developmental educator maintain professional accountability. Reports on a project conducted at the State University of New York Agricultural and Technical College at Canton during which paperwork was reduced and report writing expedited through a computerized management information…

  20. Resource Management for Distributed Parallel Systems

    NASA Technical Reports Server (NTRS)

    Neuman, B. Clifford; Rao, Santosh

    1993-01-01

    Multiprocessor systems should exist in the the larger context of distributed systems, allowing multiprocessor resources to be shared by those that need them. Unfortunately, typical multiprocessor resource management techniques do not scale to large networks. The Prospero Resource Manager (PRM) is a scalable resource allocation system that supports the allocation of processing resources in large networks and multiprocessor systems. To manage resources in such distributed parallel systems, PRM employs three types of managers: system managers, job managers, and node managers. There exist multiple independent instances of each type of manager, reducing bottlenecks. The complexity of each manager is further reduced because each is designed to utilize information at an appropriate level of abstraction.

  1. Demonstrating Reduced Gravity.

    ERIC Educational Resources Information Center

    Pearlman, Howard; And Others

    1996-01-01

    Describes the construction of the Reduced-Gravity Demonstrator, which can be used to illustrate the effects of gravity on a variety of phenomena, including the way fluids flow, flames burn, and mechanical systems behave. Presents experiments, appropriate for classroom use, to demonstrate how the behavior of common physical systems change when…

  2. Demonstrating Reduced Gravity

    NASA Technical Reports Server (NTRS)

    Pearlman, Howard; Stocker, Dennis; Gotti, Daniel; Urban, David; Ross, Howard; Sours, Thomas

    1996-01-01

    A miniature drop tower, Reduced-Gravity Demonstrator is developed to illustrate the effects of gravity on a variety of phenomena including the way fluids flow, flames burn, and mechanical systems (such as pendulum) behave. A schematic and description of the demonstrator and payloads are given, followed by suggestions for how one can build his (her) own.

  3. Reduced Braginskii equations

    SciTech Connect

    Yagi, M.; Horton, W. )

    1994-07-01

    A set of reduced Braginskii equations is derived without assuming flute ordering and the Boussinesq approximation. These model equations conserve the physical energy. It is crucial at finite [beta] that the perpendicular component of Ohm's law be solved to ensure [del][center dot][bold j]=0 for energy conservation.

  4. Reuse, Reduce, Recycle.

    ERIC Educational Resources Information Center

    Briscoe, Georgia

    1991-01-01

    Discussion of recycling paper in law libraries is also applicable to other types of libraries. Results of surveys of law libraries that investigated recycling practices in 1987 and again in 1990 are reported, and suggestions for reducing the amount of paper used and reusing as much as possible are offered. (LRW)

  5. Risk-reducing mastectomy.

    PubMed

    Chiesa, Federica; Sacchini, Virgilio S

    2016-10-01

    Mastectomy rates have significantly increased over the last decades, likely due to the rising trend of risk-reducing mastectomies (RRM) in the treatment and prevention of breast cancer. Growing evidence suggests that aggressive risk-reducing surgical strategies are only justified in high-risk breast cancer situations. Notably, in this selected cohort of women, prophylactic mastectomies offer evident benefit for local and contralateral disease control, and may also provide a survival benefit. Nevertheless, the extent of the increasing frequency of this operation is not explained by the broadening of the medical indications alone. Here we analyze the current evidence regarding RRM, its clinical practice, and possible explanations for the rising phenomenon of aggressive surgical locoregional control strategies. PMID:26785281

  6. Reducing rotor weight

    SciTech Connect

    Cheney, M.C.

    1997-12-31

    The cost of energy for renewables has gained greater significance in recent years due to the drop in price in some competing energy sources, particularly natural gas. In pursuit of lower manufacturing costs for wind turbine systems, work was conducted to explore an innovative rotor designed to reduce weight and cost over conventional rotor systems. Trade-off studies were conducted to measure the influence of number of blades, stiffness, and manufacturing method on COE. The study showed that increasing number of blades at constant solidity significantly reduced rotor weight and that manufacturing the blades using pultrusion technology produced the lowest cost per pound. Under contracts with the National Renewable Energy Laboratory and the California Energy Commission, a 400 kW (33m diameter) turbine was designed employing this technology. The project included tests of an 80 kW (15.5m diameter) dynamically scaled rotor which demonstrated the viability of the design.

  7. Reducing volcanic risk

    USGS Publications Warehouse

    Decker, R.; Decker, B.

    1991-01-01

    The last two decades have brought major advances in research on how volcanoes work and how to monitor their changing habits. Geologic mapping as well as studies of earthquake patterns and surface deformation associated with underground movement of magma have given scientists a better view of the inner structure and dynamics of active volcanoes. With the next decade, the time has come to focuses more on applying this knowledge toward reducing the risk from volcanic activity on a worldwide basis. 

  8. Gradual extinction reduces reinstatement

    PubMed Central

    Shiban, Youssef; Wittmann, Jasmin; Weißinger, Mara; Mühlberger, Andreas

    2015-01-01

    The current study investigated whether gradually reducing the frequency of aversive stimuli during extinction can prevent the return of fear. Thirty-one participants of a three-stage procedure (acquisition, extinction and a reinstatement test on day 2) were randomly assigned to a standard extinction (SE) and gradual extinction (GE) procedure. The two groups differed only in the extinction procedure. While the SE group ran through a regular extinction process without any negative events, the frequency of the aversive stimuli during the extinction phase was gradually reduced for the GE group. The unconditioned stimulus (US) was an air blast (5 bar, 10 ms). A spider and a scorpion were used as conditioned stimuli (CS). The outcome variables were contingency ratings and physiological measures (skin conductance response, SCR and startle response). There were no differences found between the two groups for the acquisition and extinction phases concerning contingency ratings, SCR, or startle response. GE compared to SE significantly reduced the return of fear in the reinstatement test for the startle response but not for SCR or contingency ratings. This study was successful in translating the findings in rodent to humans. The results suggest that the GE process is suitable for increasing the efficacy of fear extinction. PMID:26441581

  9. Naval electrochemical corrosion reducer

    DOEpatents

    Clark, Howard L.

    1991-10-01

    A corrosion reducer for use with ships having a hull, a propeller mounted a propeller shaft and extending through the hull, bearings supporting the shaft, at least one thrust bearing and one seal. The improvement includes a current collector and a current reduction assembly for reducing the voltage between the hull and shaft in order to reduce corrosion due to electrolytic action. The current reduction assembly includes an electrical contact, the current collector, and the hull. The current reduction assembly further includes a device for sensing and measuring the voltage between the hull and the shaft and a device for applying a reverse voltage between the hull and the shaft so that the resulting voltage differential is from 0 to 0.05 volts. The current reduction assembly further includes a differential amplifier having a voltage differential between the hull and the shaft. The current reduction assembly further includes an amplifier and a power output circuit receiving signals from the differential amplifier and being supplied by at least one current supply. The current selector includes a brush assembly in contact with a slip ring over the shaft so that its potential may be applied to the differential amplifier.

  10. Reduce energy use

    SciTech Connect

    Welch, J.B.

    1997-07-01

    With the rising costs of utilities, Crystals International, Inc. (Plant City, Fla.), a producer of freeze-dried products for the chemical process industries, was exploring various methods to reduce energy consumption. For years, the firm had been concerned about energy costs, considering that dehydration is energy-intensive, with natural gas a major item in overhead expenses. The gas is used to fire boilers and provide steam to operate jet ejectors supplied by Croll-Reynolds (Westfield, NJ), which in turn supply the vacuum for the dehydration process. In efforts to increase efficiency and save money, Crystals International decided to replace two older boilers with a single, high-capacity unit. Producing 13,800 lb/h of 200-psig steam, the unit`s main purpose was to supply the plant`s two steam ejectors and a variety of other process needs. However, with the new boiler, system pressure would be increased and the ejector nozzles would see steam at 150 psig. This was a problem since the nozzles were designed to operate at 115-psig steam. To solve the problem, a pressure reducer, placed before the steam reached the nozzles was considered. However, Crystals International determined that reducing pressure promoted formation of potentially damaging condensate. The only alternative then, was to redesign the ejectors to accept the new system parameters.

  11. Minocycline reduces ethanol drinking.

    PubMed

    Agrawal, R G; Hewetson, A; George, C M; Syapin, P J; Bergeson, S E

    2011-06-01

    Alcoholism is a disease characterized by continued alcohol consumption despite recurring negative consequences. Thus, medications that reduce the drive to consume alcohol can be beneficial in treating alcoholism. The neurobiological systems that regulate alcohol consumption are complex and not fully understood. Currently, medications are available to treat alcoholism that act either by causing accumulation of a toxic metabolite of ethanol, or by targeting specific transmitter receptors. The purpose of our study was to investigate a new potential therapeutic pathway, neuroimmune interactions, for effects on ethanol consumption. We hypothesized that neuroimmune activity of brain glia may have a role in drinking. We utilized minocycline, a second generation tetracycline antibiotic that has immune modulatory actions, to test our hypothesis because it is known to suppress microglia, and to a lesser extent astroglia, activity following many types of insults to the brain. Treatment with 50mg/kg minocycline significantly reduced ethanol intake in male and female C57Bl/6J mice using a free choice voluntary drinking model. Saline injections did not alter ethanol intake. Minocycline had little effect on water intake or body weight change. The underlying mechanism whereby minocycline reduced ethanol intake requires further study. The results suggest that drugs that alter neuroimmune pathways may represent a new approach to developing additional therapies to treat alcoholism. PMID:21397005

  12. Managing Fault Management Development

    NASA Technical Reports Server (NTRS)

    McDougal, John M.

    2010-01-01

    As the complexity of space missions grows, development of Fault Management (FM) capabilities is an increasingly common driver for significant cost overruns late in the development cycle. FM issues and the resulting cost overruns are rarely caused by a lack of technology, but rather by a lack of planning and emphasis by project management. A recent NASA FM Workshop brought together FM practitioners from a broad spectrum of institutions, mission types, and functional roles to identify the drivers underlying FM overruns and recommend solutions. They identified a number of areas in which increased program and project management focus can be used to control FM development cost growth. These include up-front planning for FM as a distinct engineering discipline; managing different, conflicting, and changing institutional goals and risk postures; ensuring the necessary resources for a disciplined, coordinated approach to end-to-end fault management engineering; and monitoring FM coordination across all mission systems.

  13. Orthopaedic Management of Spasticity.

    PubMed

    Pidgeon, Tyler S; Ramirez, Jose M; Schiller, Jonathan R

    2015-12-01

    Spasticity is a common manifestation of many neurological conditions including multiple sclerosis, stroke, cerebral palsy, traumatic brain injury, and spinal cord injuries. Management of spasticity seeks to reduce its burden on patients and to limit secondary complications. Non-operative interventions including stretching/splinting, postural management, physical therapy/strengthening, anti-spasticity medications, and botulinum toxin injections may help patients with spasticity. Surgical management of these conditions, however, is often necessary to improve quality of life and prevent complications. Orthopaedic surgeons manage numerous sequelae of spasticity, including joint contractures, hip dislocations, scoliosis, and deformed extremities. When combined with the efforts of rehabilitation specialists, neurologists, and physical/occupational therapists, the orthopaedic management of spasticity can help patients maintain and regain function and independence as well as reduce the risk of long-tem complications. PMID:26623452

  14. Adaptive Management

    EPA Science Inventory

    Adaptive management is an approach to natural resource management that emphasizes learning through management where knowledge is incomplete, and when, despite inherent uncertainty, managers and policymakers must act. Unlike a traditional trial and error approach, adaptive managem...

  15. Coating Reduces Ice Adhesion

    NASA Technical Reports Server (NTRS)

    Smith, Trent; Prince, Michael; DwWeese, Charles; Curtis, Leslie

    2008-01-01

    The Shuttle Ice Liberation Coating (SILC) has been developed to reduce the adhesion of ice to surfaces on the space shuttle. SILC, when coated on a surface (foam, metal, epoxy primer, polymer surfaces), will reduce the adhesion of ice by as much as 90 percent as compared to the corresponding uncoated surface. This innovation is a durable coating that can withstand several cycles of ice growth and removal without loss of anti-adhesion properties. SILC is made of a binder composed of varying weight percents of siloxane(s), ethyl alcohol, ethyl sulfate, isopropyl alcohol, and of fine-particle polytetrafluoroethylene (PTFE). The combination of these components produces a coating with significantly improved weathering characteristics over the siloxane system alone. In some cases, the coating will delay ice formation and can reduce the amount of ice formed. SILC is not an ice prevention coating, but the very high water contact angle (greater than 140 ) causes water to readily run off the surface. This coating was designed for use at temperatures near -170 F (-112 C). Ice adhesion tests performed at temperatures from -170 to 20 F (-112 to -7 C) show that SILC is a very effective ice release coating. SILC can be left as applied (opaque) or buffed off until the surface appears clear. Energy dispersive spectroscopy (EDS) and x-ray photoelectron spectroscopy (XPS) data show that the coating is still present after buffing to transparency. This means SILC can be used to prevent ice adhesion even when coating windows or other objects, or items that require transmission of optical light. Car windshields are kept cleaner and SILC effectively mitigates rain and snow under driving conditions.

  16. Reducing disinfectant wastage.

    PubMed

    Kaye, S B; Graham, R; McCarthy, K; Green, J R; Damjanovic, V; Austin, M

    1991-01-01

    In order to lower departmental costs in an ophthalmological outpatient department by reducing wastage, the stability of available chlorine at levels of 280 ppm and 560 ppm in litre solutions of sodium dichloroisocyanurate was investigated over a three-week period. There was no significant decay in available chlorine at these levels in solutions kept at 20 degrees C. Sodium dichloroisocyanurate may be prepared on a weekly instead of a daily basis with an annual saving of 1200 pounds to 1400 pounds. PMID:2060659

  17. Energy Management in Municipal Buildings.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Community Affairs, Boston. Energy Conservation Project.

    This manual is written for the manager or supervisor responsible for instituting an energy management program for municipal buildings. An introduction discusses the management issues facing municipal government in dealing with the need to reduce energy consumption. The guide reviews methods for central coordination of activity to ensure that…

  18. Reducing stillbirths: interventions during labour

    PubMed Central

    Darmstadt, Gary L; Yakoob, Mohammad Yawar; Haws, Rachel A; Menezes, Esme V; Soomro, Tanya; Bhutta, Zulfiqar A

    2009-01-01

    Background Approximately one million stillbirths occur annually during labour; most of these stillbirths occur in low and middle-income countries and are associated with absent, inadequate, or delayed obstetric care. The low proportion of intrapartum stillbirths in high-income countries suggests that intrapartum stillbirths are largely preventable with quality intrapartum care, including prompt recognition and management of intrapartum complications. The evidence for impact of intrapartum interventions on stillbirth and perinatal mortality outcomes has not yet been systematically examined. Methods We undertook a systematic review of the published literature, searching PubMed and the Cochrane Library, of trials and reviews (N = 230) that reported stillbirth or perinatal mortality outcomes for eight interventions delivered during labour. Where eligible randomised controlled trials had been published after the most recent Cochrane review on any given intervention, we incorporated these new trial findings into a new meta-analysis with the Cochrane included studies. Results We found a paucity of studies reporting statistically significant evidence of impact on perinatal mortality, especially on stillbirths. Available evidence suggests that operative delivery, especially Caesarean section, contributes to decreased stillbirth rates. Induction of labour rather than expectant management in post-term pregnancies showed strong evidence of impact, though there was not enough evidence to suggest superior safety for the fetus of any given drug or drugs for induction of labour. Planned Caesarean section for term breech presentation has been shown in a large randomised trial to reduce stillbirths, but the feasibility and consequences of implementing this intervention routinely in low-/middle-income countries add caveats to recommending its use. Magnesium sulphate for pre-eclampsia and eclampsia is effective in preventing eclamptic seizures, but studies have not demonstrated impact

  19. Information management

    NASA Technical Reports Server (NTRS)

    Ricks, Wendell; Corker, Kevin

    1990-01-01

    Primary Flight Display (PFD) information management and cockpit display of information management research is presented in viewgraph form. The information management problem in the cockpit, information management burdens, the key characteristics of an information manager, the interface management system handling the flow of information and the dialogs between the system and the pilot, and overall system architecture are covered.

  20. Reducing Adolescent Obesity through a School Health Program.

    ERIC Educational Resources Information Center

    Botvin, G. J.; And Others

    1979-01-01

    A 10-session weight reduction program that included behavior modification, nutrition education, and exercise management was found to be effective in reducing weight. (Author/DLS) Journal Availability: C. V. Mosby Company, 11830 Westline Industrial Dr., St. Louis, MO 63141

  1. Leveraging Technology to Reduce Patient Transaction Costs.

    PubMed

    Edlow, Richard C

    2015-01-01

    Medical practices are under significant pressure to provide superior customer service in an environment of declining or flat reimbursement. The solution for many practices involves the integration of a variety of third-party technologies that conveniently interface with one's electronic practice management and medical records systems. Typically, the applications allow the practice to reduce the cost of each patient interaction. Drilling down to quantify the cost of each individual patient interaction helps to determine the practicality of implementation. PMID:26665478

  2. Pressure reducing regulator

    DOEpatents

    Whitehead, John C.; Dilgard, Lemoyne W.

    1995-01-01

    A pressure reducing regulator that controls its downstream or outlet pressure to a fixed fraction of its upstream or inlet pressure. The regulator includes a housing which may be of a titanium alloy, within which is located a seal or gasket at the outlet end which may be made of annealed copper, a rod, and piston, each of which may be made of high density graphite. The regulator is insensitive to temperature by virtue of being without a spring or gas sealed behind a diaphragm, and provides a reference for a system in which it is being used. The rod and piston of the regulator are constructed, for example, to have a 1/20 ratio such that when the downstream pressure is less than 1/20 of the upstream pressure the regulator opens and when the downstream pressure exceeds 1/20 of the upstream pressure the regulator closes.

  3. Pressure reducing regulator

    DOEpatents

    Whitehead, J.C.; Dilgard, L.W.

    1995-10-10

    A pressure reducing regulator that controls its downstream or outlet pressure to a fixed fraction of its upstream or inlet pressure is disclosed. The regulator includes a housing which may be of a titanium alloy, within which is located a seal or gasket at the outlet end which may be made of annealed copper, a rod, and piston, each of which may be made of high density graphite. The regulator is insensitive to temperature by virtue of being without a spring or gas sealed behind a diaphragm, and provides a reference for a system in which it is being used. The rod and piston of the regulator are constructed, for example, to have a 1/20 ratio such that when the downstream pressure is less than 1/20 of the upstream pressure the regulator opens and when the downstream pressure exceeds 1/20 of the upstream pressure the regulator closes. 10 figs.

  4. Embodied intervention reduce depression

    NASA Astrophysics Data System (ADS)

    Song, Dong-Qing; Bi, Xin; Fu, Ying

    2011-10-01

    To investigate the difference of the selected-rate of undergraduates' depression with respect to time, gender and scales and the intervention effect of embodied exercise, 201 Undergraduates were measured with Self-Rating Depression Scale and Beck Depression Inventory (BDI).The result shows there are significant difference of the selected-rates of undergraduates' depression resulted from long-time interval rather than from short-time interval and gender. After the intervention, the selected-rates are decreased and no significant difference has been found between the embodied groups and the controlled group. Only the embodied groups maintain the better effects of the intervention in the tracking. Also the result shows that only the participants of embodied groups obtain more positive emotional experience. We conclude that there is significant difference of selected-rate of undergraduates' depression on scales, and the embodied exercise can effectively reduce undergraduate's depression.

  5. Reducing Penguin Pollution

    NASA Astrophysics Data System (ADS)

    Bhattacharya, Bhubanjyoti; Datta, Alakabha; London, David

    2013-06-01

    The most common decay used for measuring 2βs, the phase of B0s--\\bar B0s mixing, is B0s-> J/ψ φ . This decay is dominated by the color-suppressed tree diagram, but there are other contributions due to gluonic and electroweak penguin diagrams. These are often referred to as "penguin pollution" (PP) because their inclusion in the amplitude leads to a theoretical error in the extraction of 2βs from the data. In the standard model (SM), it is estimated that the PP is negligible, but there is some uncertainty as to its exact size. Now, φ sc\\bar {cs} (the measured value of 2βs) is small, in agreement with the SM, but still has significant experimental errors. When these are reduced, if one hopes to be able to see clear evidence of new physics (NP), it is crucial to have the theoretical error under control. In this paper, we show that, using a modification of the angular analysis currently used to measure φ sc\\bar {cs} in B0s-> J/ψ φ , one can reduce the theoretical error due to PP. Theoretical input is still required, but it is much more modest than entirely neglecting the PP. If φ sc\\bar {cs} differs from the SM prediction, this points to NP in the mixing. There is also enough information to test for NP in the decay. This method can be applied to all B0s/\\bar B0s -> V1 V2 decays.

  6. Reducing transfusion requirements in liver transplantation

    PubMed Central

    Donohue, Ciara I; Mallett, Susan V

    2015-01-01

    Liver transplantation (LT) was historically associated with massive blood loss and transfusion. Over the past two decades transfusion requirements have reduced dramatically and increasingly transfusion-free transplantation is a reality. Both bleeding and transfusion are associated with adverse outcomes in LT. Minimising bleeding and reducing unnecessary transfusions are therefore key goals in the perioperative period. As the understanding of the causes of bleeding has evolved so too have techniques to minimize or reduce the impact of blood loss. Surgical “piggyback” techniques, anaesthetic low central venous pressure and haemodilution strategies and the use of autologous cell salvage, point of care monitoring and targeted correction of coagulopathy, particularly through use of factor concentrates, have all contributed to declining reliance on allogenic blood products. Pre-emptive management of preoperative anaemia and adoption of more restrictive transfusion thresholds is increasingly common as patient blood management (PBM) gains momentum. Despite progress, increasing use of marginal grafts and transplantation of sicker recipients will continue to present new challenges in bleeding and transfusion management. Variation in practice across different centres and within the literature demonstrates the current lack of clear transfusion guidance. In this article we summarise the causes and predictors of bleeding and present the evidence for a variety of PBM strategies in LT. PMID:26722645

  7. [Acromegaly: reducing diagnostic delay].

    PubMed

    Giustina, Andrea

    2016-08-01

    Diagnostic delay of acromegaly is still very relevant (6-8 years on average) without substantial changes in last twenty years. Clinical impact of this diagnostic delay is significant: tumor growth (2/3 of the patients at diagnosis bear a pituitary macroadenoma), development of irreversible complications (arthropathy, sleep apnea) and in all increased mortality. Reasons for this delay are related to the disease itself (facial and acral changes are very slow and subtle) but also to medical unawareness. Simple tools based on a few sufficiently sensitive and specific signs and symptoms which can trigger the diagnostic suspect would be useful in clinical practice. Global evaluation during follow-up (tumor volume, signs and symptoms, complications, circulating levels of growth hormone and its peripheral mediator IGF-I) has become crucial for the therapeutic decision making. In this regard, tools like SAGIT are now under validation and are expected to improve management of acromegaly. In fact, in the last 30 years there has been a relevant growth of the medical options to treat acromegaly and in the near future there will be an expansion of the medical options. This will greatly help the needed personalization of treatment which necessarily should consider patient convenience and preference and control of complications such as diabetes mellitus. PMID:27571562

  8. Reducing pharmaceutical risk.

    PubMed

    Spilker, B

    1998-08-01

    This article describes several types of risk encountered in drug discovery, development and marketing, as well as the overall business risks in the pharmaceutical industry. Discovery risk refers to the risk companies face if they are partly or totally dependent on discovering new drugs; many avenues are presented for companies to pursue in order to decrease discovery risk. Development risk is defined as the risk that drug discoveries that enter development will not reach the market and become commercially viable drugs. To decrease development risk, it is possible to pursue one or more of the approaches presented. Significant marketing risks for a company include that the sales forecasts will not be met, the positioning of a drug may not be correct or optimal and the sales force is not performing adequately. At the corporate level there are numerous major risks involved in pursuing the specific mission, objectives, strategies and tactics of the overall company as well as those in the functional areas. Many aspects of the company's business can be adjusted or changed to decrease corporate risk. Selected issues concerning risk include venture capital funds, the appetite for risk within a company and the influence of senior and middle level managers' personalities on risk. PMID:15616620

  9. Burner retrofits reduce brewery emissions

    SciTech Connect

    Not Available

    1993-04-01

    In 1988, the South Coast Air Quality Management District in California (SCAQMD) tightened its grip on industrial emissions of nitrogen oxides (NOx). The new statute, Rule 1146, mandates a 75% reduction in NOx emissions over a five-year period ending this July. Anheuser-Busch Inc.'s second-largest brewery in Van Nuys fell under the new law's jurisdiction. Under the new law, the maximum allowable NOx emission must be reduced from 120 to 30 ppm for the two largest boilers. There were two alternatives: either prevent its formation inside the boiler, or remove it from the off-gases via selective catalytic reduction (SCR) or selective non-catalytic reduction (SNCR). Prevention was chosen, because the NOx-removal technologies are unproven in the US on natural-gas-fired boilers. In addition, it was not known whether SCR or SNCR could respond to the wide swings in boiler demand. At any given time, loads between 30 and 100% of capacity would be required from the boilers. The brewery retrofitted the 125,000-lb/h boilers with Variflame burners, based upon an earlier retrofit at Anheuser-Busch's Merrimack, N.H., brewery. The paper describes this burner and its performance.

  10. Integrated, automated revenue management for managed care contracts.

    PubMed

    Burckhart, Kent

    2002-04-01

    Faced with increasing managed care penetration and declining net revenue in recent years, healthcare providers increasingly are emphasizing revenue management. To streamline processes and reduce costs in this area, many healthcare providers have implemented or are considering automated contract management systems. When selecting such a system, healthcare financial managers should make certain that the system can interface with both patient-accounting and decision-support systems of the organization. This integration enhances a healthcare provider's financial viability by providing integrated revenue-management capabilities to analyze projected performance of proposed managed care contracts and actual performance of existing contracts. PMID:11963597

  11. Measuring the reduced shear

    SciTech Connect

    Zhang, Jun

    2011-11-01

    Neglecting the second order corrections in weak lensing measurements can lead to a few percent uncertainties on cosmic shears, and becomes more important for cluster lensing mass reconstructions. Existing methods which claim to measure the reduced shears are not necessarily accurate to the second order when a point spread function (PSF) is present. We show that the method of Zhang (2008) exactly measures the reduced shears at the second order level in the presence of PSF. A simple theorem is provided for further confirming our calculation, and for judging the accuracy of any shear measurement method at the second order based on its properties at the first order. The method of Zhang (2008) is well defined mathematically. It does not require assumptions on the morphologies of galaxies and the PSF. To reach a sub-percent level accuracy, the CCD pixel size is required to be not larger than 1/3 of the Full Width at Half Maximum (FWHM) of the PSF, regardless of whether the PSF has a power-law or exponential profile at large distances. Using a large ensemble (∼>10{sup 7}) of mock galaxies of unrestricted morphologies, we study the shear recovery accuracy under different noise conditions. We find that contaminations to the shear signals from the noise of background photons can be removed in a well defined way because they are not correlated with the source shapes. The residual shear measurement errors due to background noise are consistent with zero at the sub-percent level even when the amplitude of such noise reaches about 1/10 of the source flux within the half-light radius of the source. This limit can in principle be extended further with a larger galaxy ensemble in our simulations. On the other hand, the source Poisson noise remains to be a cause of systematic errors. For a sub-percent level accuracy, our method requires the amplitude of the source Poisson noise to be less than 1/80 ∼ 1/100 of the source flux within the half-light radius of the source

  12. Managed health care.

    PubMed

    Curtiss, F R

    1989-04-01

    The fundamental components of managed-care plans are described; the development of managed-care programs is discussed; and the impact of managed care on pharmacy services and the price, quality, and accessibility of health care are reviewed. Health care can be considered to be managed when at least one of the following fundamental components is present: prospective pricing, "UCR" (usual, customary, and reasonable) pricing of services, peer review, mandatory use review, benefit redesign, capitation payments, channeling, quality criteria, and health promotion. The managed-care industry consists of health maintenance organizations (HMOs), preferred provider organizations (PPOs), and managed fee-for-service plans. Managed-care reimbursement principles involve transferring some or all of the impetus for controlling use of services to the health-care provider. Means by which this is done include prospective pricing, services bundling, price discounts and negotiated fees, and capitation financing and reimbursement. Financial risk-sharing arrangements with providers--including hospitals, physicians, pharmacies, and home-care companies--are necessary for any managed-care plan to attain true control over its service costs. Use-review and use-management services are also fundamental to containing health-care spending. These include retrospective, concurrent, and prospective reviews of the necessity and appropriateness of medical services. Use management, like services bundling and prospective pricing, has been more effective in reducing costs of hospital inpatient services than costs associated with ambulatory care. Per case payments and services bundling have made individual charges for items irrelevant to hospital revenue. This has forced hospital pharmacy managers to become more sensitive to cost management. Drug formularies, improved productivity, and use of prescribing protocols are means by which hospital pharmacies have controlled costs. However, since shorter hospital

  13. Generalized reduced MHD equations

    SciTech Connect

    Kruger, S.E.; Hegna, C.C.; Callen, J.D.

    1998-07-01

    A new derivation of reduced magnetohydrodynamic (MHD) equations is presented. A multiple-time-scale expansion is employed. It has the advantage of clearly separating the three time scales of the problem associated with (1) MHD equilibrium, (2) fluctuations whose wave vector is aligned perpendicular to the magnetic field, and (3) those aligned parallel to the magnetic field. The derivation is carried out without relying on a large aspect ratio assumption; therefore this model can be applied to any general toroidal configuration. By accounting for the MHD equilibrium and constraints to eliminate the fast perpendicular waves, equations are derived to evolve scalar potential quantities on a time scale associated with the parallel wave vector (shear-alfven wave time scale), which is the time scale of interest for MHD instability studies. Careful attention is given in the derivation to satisfy energy conservation and to have manifestly divergence-free magnetic fields to all orders in the expansion parameter. Additionally, neoclassical closures and equilibrium shear flow effects are easily accounted for in this model. Equations for the inner resistive layer are derived which reproduce the linear ideal and resistive stability criterion of Glasser, Greene, and Johnson.

  14. Cancer Reduces Transcriptome Specialization

    PubMed Central

    Martínez, Octavio; Reyes-Valdés, M. Humberto; Herrera-Estrella, Luis

    2010-01-01

    A central goal of cancer biology is to understand how cells from this family of genetic diseases undergo specific morphological and physiological changes and regress to a de-regulated state of the cell cycle. The fact that tumors are unable to perform most of the specific functions of the original tissue led us to hypothesize that the degree of specialization of the transcriptome of cancerous tissues must be less than their normal counterparts. With the aid of information theory tools, we analyzed four datasets derived from transcriptomes of normal and tumor tissues to quantitatively test the hypothesis that cancer reduces transcriptome specialization. Here, we show that the transcriptional specialization of a tumor is significantly less than the corresponding normal tissue and comparable with the specialization of dedifferentiated embryonic stem cells. Furthermore, we demonstrate that the drop in specialization in cancerous tissues is largely due to a decrease in expression of genes that are highly specific to the normal organ. This approach gives us a better understanding of carcinogenesis and offers new tools for the identification of genes that are highly influential in cancer progression. PMID:20454660

  15. Reducing medical waste.

    PubMed

    Conrardy, Julie; Hillanbrand, Mary; Myers, Sandra; Nussbaum, George F

    2010-06-01

    Medical waste is a necessary by-product of any hospital environment; however, the majority of regulated medical waste is produced in the OR from the use of disposable surgical supplies (eg, drapes, gowns, basins, gloves, sponges). We conducted a concept comparison project in the ORs of two large medical centers in Bethesda, Maryland, and Washington, DC, to evaluate the effects of using reusable surgical basins, gowns, and table and Mayo stand covers in place of disposable products. Survey results indicated that surgeons and surgical technologists found the reusable products to be preferable to the disposable products currently in use. In addition, using reusable products provided a means to decrease regulated medical waste generated in the OR by an average of 65% as well as reduce the cost of waste disposal. AORN recommends evaluating the environmental effects of using reusable, reposable, and disposable products; our findings provide evidence that may be useful to surgical facilities that seek to adopt a "green" approach. PMID:20510944

  16. Reducing miner absenteeism

    SciTech Connect

    Peters, R.H.; Clingan, M.R.; Randolph, R.F.

    1989-01-01

    The U. S. Bureau of Mines has prepared this report on strategies for maintaining high job attendance among underground coal miners because high absenteeism is a threat to miners' safety and seriously hampers productivity. A substantial number of research studies on the effectiveness of various strategies for reducing absenteeism among the employees of nonmining industries have been reported in the literature. These strategies have aimed at improving job attendance through one or more of the following: (1) improving employment procedures, (2) overcoming problems that adversely affect one's ability to attend work, and (3) increasing miners' motivation to attend work. Many of these strategies appear applicable to the mining industry, and are reviewed in the first half of this report. The second half of this report describes how one could develop and implement a program for maintaining high attendance at underground coal mines. The steps include measuring and evaluating attendance levels, formulating attendance goals and an absenteeism policy, developing and implementing an attendance promotion program and periodically going through the preceding steps (known as recycling).

  17. Stewarding a Reduced Stockpile

    SciTech Connect

    Goodwin, B T; Mara, G

    2008-04-18

    The future of the US nuclear arsenal continues to be guided by two distinct drivers: the preservation of world peace and the prevention of further proliferation through our extended deterrent umbrella. Timely implementation of US nuclear policy decisions depends, in part, on the current state of stockpile weapons, their delivery systems, and the supporting infrastructure within the Department of Defense (DoD) and the Department of Energy's National Nuclear Security Administration (NNSA). In turn, the present is a product of past choices and world events. Now more than ever, the nuclear weapons program must respond to the changing global security environment and to increasing budget pressures with innovation and sound investments. As the nation transitions to a reduced stockpile, the successes of the Stockpile Stewardship Program (SSP) present options to transition to a sustainable complex better suited to stockpile size, national strategic goals and budgetary realities. Under any stockpile size, we must maintain essential human capital, forefront capabilities, and have a right-sized effective production capacity. We present new concepts for maintaining high confidence at low stockpile numbers and to effectively eliminate the reserve weapons within an optimized complex. We, as a nation, have choices to make on how we will achieve a credible 21st century deterrent.

  18. Generalized reduced magnetohydrodynamic equations

    SciTech Connect

    Kruger, S.E.

    1999-02-01

    A new derivation of reduced magnetohydrodynamic (MHD) equations is presented. A multiple-time-scale expansion is employed. It has the advantage of clearly separating the three time scales of the problem associated with (1) MHD equilibrium, (2) fluctuations whose wave vector is aligned perpendicular to the magnetic field, and (3) those aligned parallel to the magnetic field. The derivation is carried out without relying on a large aspect ratio assumption; therefore this model can be applied to any general configuration. By accounting for the MHD equilibrium and constraints to eliminate the fast perpendicular waves, equations are derived to evolve scalar potential quantities on a time scale associated with the parallel wave vector (shear-Alfven wave time scale), which is the time scale of interest for MHD instability studies. Careful attention is given in the derivation to satisfy energy conservation and to have manifestly divergence-free magnetic fields to all orders in the expansion parameter. Additionally, neoclassical closures and equilibrium shear flow effects are easily accounted for in this model. Equations for the inner resistive layer are derived which reproduce the linear ideal and resistive stability criterion of Glasser, Greene, and Johnson. The equations have been programmed into a spectral initial value code and run with shear flow that is consistent with the equilibrium input into the code. Linear results of tearing modes with shear flow are presented which differentiate the effects of shear flow gradients in the layer with the effects of the shear flow decoupling multiple harmonics.

  19. MANAGEMENT PROGRAMS FOR REDUCING RISKS OF ASTHMA IN CHILDREN

    EPA Science Inventory

    This paper reviews available national cost of asthma estimates and updates them to 1997, accounting for increases in prices of medical goods and services, changes in the usage of asthma-related medical goods and services, and changes in asthma prevalence and mortality. Available ...

  20. Water management: a key to reducing nitrogen losses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving yield per unit water applied has probably always been the goal of irrigators. This ratio of yield per unit water was some 40 years ago named water use efficiency (WUE). This emphasized obtaining the maximum yield for a given irrigation amount, often by increasing fertilizer applications, u...

  1. Management Options for Reducing Ammonia Emissions from Poultry Litter

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ammonia emissions from poultry litter not only result in air pollution; high levels of ammonia in poultry houses cause poor bird performance, increase the susceptibility of birds to viral diseases, and negatively impact human health. Although ammonia emissions are a concern, few cost-effective best ...

  2. WATER MANAGEMENT – A KEY TO REDUCING NITROGEN LOSSES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving yield per unit water applied has probably always been the goal of irrigators. This ratio of yield per unit water was some 40 years ago named water use efficiency (WUE). This emphasized obtaining the maximum yield for a given irrigation amount, often by increasing fertilizer applications, u...

  3. Management strategies to reduce environmental impact from soil fumigation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Soil fumigation is an important agronomic practice for controlling soil-borne plant pests. However, all fumigant chemicals have relatively high vapor pressure values and are prone to emission losses to the ambient atmosphere. This poses significant safety and human health concerns for farmers and ...

  4. Management Strategies to Reduce Embryonic Loss in Beef Cattle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mechanisms involved in pregnancy establishment and maintenance in cattle are complex. Approximately 95% of matings, regardless of whether they are by artificial insemination or natural service, result in fertilization. However, rarely do 70% of these matings result in a pregnancy that is maintaine...

  5. WATER MANAGEMENT-A KEY TO REDUCING NITROGEN LOSSES

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Improving yield per unit water applied has probably always been the goal of irrigators. This ratio of yield per unit water was some 40 years ago named water use efficiency (WUE). This emphasized obtaining the maximum yield for a given irrigation amount, often by increasing fertilizer applications, u...

  6. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Reducing long supply...-Maximizing Use of Inventories § 101-27.303 Reducing long supply. Through effective interagency matching of... curtailing procurement and by utilizing and redistributing long supply. (The term long supply means...

  7. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Reducing long supply. 101...-Maximizing Use of Inventories § 101-27.303 Reducing long supply. Through effective interagency matching of... curtailing procurement and by utilizing and redistributing long supply. (The term long supply means...

  8. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Reducing long supply. 101...-Maximizing Use of Inventories § 101-27.303 Reducing long supply. Through effective interagency matching of... curtailing procurement and by utilizing and redistributing long supply. (The term long supply means...

  9. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Reducing long supply. 101...-Maximizing Use of Inventories § 101-27.303 Reducing long supply. Through effective interagency matching of... curtailing procurement and by utilizing and redistributing long supply. (The term long supply means...

  10. 41 CFR 101-27.303 - Reducing long supply.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Reducing long supply. 101...-Maximizing Use of Inventories § 101-27.303 Reducing long supply. Through effective interagency matching of... curtailing procurement and by utilizing and redistributing long supply. (The term long supply means...

  11. Trained Home Composters Reduce Solid Waste by 18%.

    ERIC Educational Resources Information Center

    Vossen, Paul; Rilla, Ellen

    1996-01-01

    In the University of California Cooperative Extension's Master Gardener Program, a partnership with the Sonoma County Waste Management Agency, volunteers teach approximately 1000 people annually how to compost in their backyards to help reduce landfill waste. Surveys conducted in 1995 and 1996 showed that home composters reduced their input into…

  12. Reduced Tillage in a Three Year Potato Rotation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Tillage in most crop rotations is used to prepare seed-beds, control weeds and other pests, manage crop residues, reduce soil compaction, and incorporate fertilizer and pesticides. Adopting conservation tillage to reduce erosion, increase N use efficiency, and build organic matter would improve soi...

  13. National Policy Agenda to Reduce the Burden of Student Debt

    ERIC Educational Resources Information Center

    Institute for College Access & Success, 2014

    2014-01-01

    Since 2005, "The Institute for College Access & Success" (TICAS) and its Project on Student Debt have worked to reduce the risks and burdens of student debt. TICAS helped create and improve income-based repayment plans to keep federal loan payments manageable; strengthen Pell Grants, which reduce the need to borrow; and simplify the…

  14. 5 CFR 842.612 - Post-retirement election of a fully reduced annuity or one-half reduced annuity to provide a...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... reduced annuity or one-half reduced annuity to provide a current spouse annuity. 842.612 Section 842.612 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL... reduced annuity or one-half reduced annuity to provide a current spouse annuity. (a) Except as provided...

  15. Management of fetal malpresentation.

    PubMed

    Sharshiner, Rita; Silver, Robert M

    2015-06-01

    Fetal malpresentation is an important cause of the high cesarean delivery rate in the United States and around the world. This includes breech, face, brow, and compound presentations as well as transverse lie. Risk factors include multiparity, previously affected pregnancy, polyhydramnios, and fetal and uterine anomalies. Appropriate management can reduce the need for cesarean delivery in some cases. This review discusses management options and focuses specifically on external cephalic version and vaginal breech delivery. PMID:25811125

  16. Risk Management

    NASA Technical Reports Server (NTRS)

    Thomas, Lloyd

    1998-01-01

    This presentation focuses on the identification of risk management, risk management processes such as: quantification and prioritization; mitigation planning; implementation of risk reduction; and tracking process. It develops examples and answers questions about Risk Management.

  17. Network Management Framework for Wireless Sensor Networks

    NASA Astrophysics Data System (ADS)

    Kim, Jaewoo; Jeon, Hahnearl; Lee, Jaiyong

    Network Management is the process of managing, monitoring, and controlling the network. Conventional network management was based on wired network which is heavy and unsuitable for resource constrained WSNs. WSNs can have large scale network and it is impossible to manage each node individually. Also, polling mechanism of Simple Network Management Protocol (SNMP) impose heavy management traffic overhead. Since management messages consume resources of WSNs, it can affect the performance of the network. Therefore, it is necessary for WSNs to perform energy efficient network management. In this paper, we will propose network management framework. We will introduce cluster-based network management architecture, and classify the Management Information Base (MIB) according to their characteristics. Then, we will define management messages and message exchange operation for each kind of MIB. The analysis result of the management overhead indicates that the proposed framework can reduce management traffic compared to polling mechanism.

  18. MapReduceXMT v. Beta 0.1

    Energy Science and Technology Software Center (ESTSC)

    2010-02-24

    The MapReduceXMT library ports the MapReduce framework onto the Cray XMT. MapReduce is a programming paradigm and an approach to data management for unstructured problems. It has gained relevance due to its ability to map serial operations onto parallel distributed architectures, significantly improving developer/analyst productivity. The MapReduceXMT implements the key aspects of MapReduce for the Cray XMT, a massively threaded system that is inherently difficult to program. MapReduceXMT allows users to utilize the machine effectivelymore » and efficiently without extensive training in multi-threaded programming. The MapReduceXMT library ports the MapReduce framework onto the Cray XMT. MapReduce is a programming paradigm and an approach to data management for unstructured problems. It has gained relevance due to its ability to map serial operations onto parallel distributed architectures, significantly improving developer/analyst productivity. The MapReduceXMT implements the key aspects of MapReduce for the Cray XMT, a massively threaded system that is inherently difficult to program. MapReduceXMT allows users to utilize the machine effectively and efficiently without extensive training in multi-threaded programming.« less

  19. 5 CFR 831.631 - Post-retirement election of fully reduced annuity or partially reduced annuity to provide a...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Post-retirement election of fully reduced annuity or partially reduced annuity to provide a current spouse annuity. 831.631 Section 831.631 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS...

  20. AGRICULTURAL BEST MANAGEMENT PRACTICE EFFECTIVENESS DATABASE

    EPA Science Inventory

    Resource Purpose:The Agricultural Best Management Practice Effectiveness Database contains the results of research projects which have collected water quality data for the purpose of determining the effectiveness of agricultural management practices in reducing pollutants ...

  1. Reducing gas generators and methods for generating a reducing gas

    SciTech Connect

    Scotto, Mark Vincent; Perna, Mark Anthony

    2015-11-03

    One embodiment of the present invention is a unique reducing gas generator. Another embodiment is a unique method for generating a reducing gas. Other embodiments include apparatuses, systems, devices, hardware, methods, and combinations for generating reducing gas. Further embodiments, forms, features, aspects, benefits, and advantages of the present application will become apparent from the description and figures provided herewith.

  2. Managing hybrid marketing systems.

    PubMed

    Moriarty, R T; Moran, U

    1990-01-01

    As competition increases and costs become critical, companies that once went to market only one way are adding new channels and using new methods - creating hybrid marketing systems. These hybrid marketing systems hold the promise of greater coverage and reduced costs. But they are also hard to manage; they inevitably raise questions of conflict and control: conflict because marketing units compete for customers; control because new indirect channels are less subject to management authority. Hard as they are to manage, however, hybrid marketing systems promise to become the dominant design, replacing the "purebred" channel strategy in all kinds of businesses. The trick to managing the hybrid is to analyze tasks and channels within and across a marketing system. A map - the hybrid grid - can help managers make sense of their hybrid system. What the chart reveals is that channels are not the basic building blocks of a marketing system; marketing tasks are. The hybrid grid forces managers to consider various combinations of channels and tasks that will optimize both cost and coverage. Managing conflict is also an important element of a successful hybrid system. Managers should first acknowledge the inevitability of conflict. Then they should move to bound it by creating guidelines that spell out which customers to serve through which methods. Finally, a marketing and sales productivity (MSP) system, consisting of a central marketing database, can act as the central nervous system of a hybrid marketing system, helping managers create customized channels and service for specific customer segments. PMID:10107959

  3. Exploiting Data Similarity to Reduce Memory Footprints

    SciTech Connect

    Biswas, S; de Supinski, B R; Schulz, M; Franklin, D; Sherwood, T; Chong, F T

    2011-01-28

    Memory size has long limited large-scale applications on high-performance computing (HPC) systems. Since compute nodes frequently do not have swap space, physical memory often limits problem sizes. Increasing core counts per chip and power density constraints, which limit the number of DIMMs per node, have exacerbated this problem. Further, DRAM constitutes a significant portion of overall HPC system cost. Therefore, instead of adding more DRAM to the nodes, mechanisms to manage memory usage more efficiently - preferably transparently - could increase effective DRAM capacity and thus the benefit of multicore nodes for HPC systems. MPI application processes often exhibit significant data similarity. These data regions occupy multiple physical locations across the individual rank processes within a multicore node and thus offer a potential savings in memory capacity. These regions, primarily residing in heap, are dynamic, which makes them difficult to manage statically. Our novel memory allocation library, SBLLmalloc, automatically identifies identical memory blocks and merges them into a single copy. SBLLmalloc does not require application or OS changes since we implement it as a user-level library. Overall, we demonstrate that SBLLmalloc reduces the memory footprint of a range of MPI applications by 32.03% on average and up to 60.87%. Further, SBLLmalloc supports problem sizes for IRS over 21.36% larger than using standard memory management techniques, thus significantly increasing effective system size. Similarly, SBLLmalloc requires 43.75% fewer nodes than standard memory management techniques to solve an AMG problem.

  4. Reducing Risks of Birth Defects

    MedlinePlus

    ... Education FAQs Reducing Risks of Birth Defects Patient Education Pamphlets - Spanish Reducing Risks of Birth Defects FAQ146, February 2016 ... Your Practice Patient Safety & Quality Payment Reform (MACRA) Education & Events Annual ... Pamphlets Teen Health About ACOG About Us Leadership & ...

  5. Database Management

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Management of the data within a planetary data system (PDS) is addressed. Principles of modern data management are described and several large NASA scientific data base systems are examined. Data management in PDS is outlined and the major data management issues are introduced.

  6. Team Management.

    ERIC Educational Resources Information Center

    Lindelow, John; Bentley, Scott

    Chapter 6 of a revised volume on school leadership, this chapter defines and explains management teams and describes several successful examples of team management. Superintendents have come to rely on their management team's expertise to resolve increasingly complex policy, administrative, and instructional issues. Although team management has…

  7. Managing Documents in the Wider Area: Intelligent Document Management.

    ERIC Educational Resources Information Center

    Bittleston, Richard

    1995-01-01

    Discusses techniques for managing documents in wide area networks, reviews technique limitations, and offers recommendations to database designers. Presented techniques include: increasing bandwidth, reducing data traffic, synchronizing documentation, partial synchronization, audit trials, navigation, and distribution control and security. Two…

  8. 3 CFR - Federal Leadership on Energy Management

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... heat sources, including biomass, solar thermal, geothermal, waste heat, and combined heat and power... better manage building performance, enhance energy efficiency, and reduce energy waste in an open...

  9. In situ mobility of uranium in the presence of nitrate following sulfate-reducing conditions

    NASA Astrophysics Data System (ADS)

    Paradis, Charles J.; Jagadamma, Sindhu; Watson, David B.; McKay, Larry D.; Hazen, Terry C.; Park, Melora; Istok, Jonathan D.

    2016-04-01

    Reoxidation and mobilization of previously reduced and immobilized uranium by dissolved-phase oxidants poses a significant challenge for remediating uranium-contaminated groundwater. Preferential oxidation of reduced sulfur-bearing species, as opposed to reduced uranium-bearing species, has been demonstrated to limit the mobility of uranium at the laboratory scale yet field-scale investigations are lacking. In this study, the mobility of uranium in the presence of nitrate oxidant was investigated in a shallow groundwater system after establishing conditions conducive to uranium reduction and the formation of reduced sulfur-bearing species. A series of three injections of groundwater (200 L) containing U(VI) (5 μM) and amended with ethanol (40 mM) and sulfate (20 mM) were conducted in ten test wells in order to stimulate microbial-mediated reduction of uranium and the formation of reduced sulfur-bearing species. Simultaneous push-pull tests were then conducted in triplicate well clusters to investigate the mobility of U(VI) under three conditions: 1) high nitrate (120 mM), 2) high nitrate (120 mM) with ethanol (30 mM), and 3) low nitrate (2 mM) with ethanol (30 mM). Dilution-adjusted breakthrough curves of ethanol, nitrate, nitrite, sulfate, and U(VI) suggested that nitrate reduction was predominantly coupled to the oxidation of reduced-sulfur bearing species, as opposed to the reoxidation of U(IV), under all three conditions for the duration of the 36-day tests. The amount of sulfate, but not U(VI), recovered during the push-pull tests was substantially more than injected, relative to bromide tracer, under all three conditions and further suggested that reduced sulfur-bearing species were preferentially oxidized under nitrate-reducing conditions. However, some reoxidation of U(IV) was observed under nitrate-reducing conditions and in the absence of detectable nitrate and/or nitrite. This suggested that reduced sulfur-bearing species may not be fully effective at

  10. In situ mobility of uranium in the presence of nitrate following sulfate-reducing conditions.

    PubMed

    Paradis, Charles J; Jagadamma, Sindhu; Watson, David B; McKay, Larry D; Hazen, Terry C; Park, Melora; Istok, Jonathan D

    2016-04-01

    Reoxidation and mobilization of previously reduced and immobilized uranium by dissolved-phase oxidants poses a significant challenge for remediating uranium-contaminated groundwater. Preferential oxidation of reduced sulfur-bearing species, as opposed to reduced uranium-bearing species, has been demonstrated to limit the mobility of uranium at the laboratory scale yet field-scale investigations are lacking. In this study, the mobility of uranium in the presence of nitrate oxidant was investigated in a shallow groundwater system after establishing conditions conducive to uranium reduction and the formation of reduced sulfur-bearing species. A series of three injections of groundwater (200 L) containing U(VI) (5 μM) and amended with ethanol (40 mM) and sulfate (20 mM) were conducted in ten test wells in order to stimulate microbial-mediated reduction of uranium and the formation of reduced sulfur-bearing species. Simultaneous push-pull tests were then conducted in triplicate well clusters to investigate the mobility of U(VI) under three conditions: 1) high nitrate (120 mM), 2) high nitrate (120 mM) with ethanol (30 mM), and 3) low nitrate (2 mM) with ethanol (30 mM). Dilution-adjusted breakthrough curves of ethanol, nitrate, nitrite, sulfate, and U(VI) suggested that nitrate reduction was predominantly coupled to the oxidation of reduced-sulfur bearing species, as opposed to the reoxidation of U(IV), under all three conditions for the duration of the 36-day tests. The amount of sulfate, but not U(VI), recovered during the push-pull tests was substantially more than injected, relative to bromide tracer, under all three conditions and further suggested that reduced sulfur-bearing species were preferentially oxidized under nitrate-reducing conditions. However, some reoxidation of U(IV) was observed under nitrate-reducing conditions and in the absence of detectable nitrate and/or nitrite. This suggested that reduced sulfur-bearing species may not be fully effective at

  11. The Management of Management Games.

    ERIC Educational Resources Information Center

    Bryant, Nigel; Corless, Helen

    1986-01-01

    This discussion of whether management games should be used for managerial performance appraisal addresses definitions, features, and purposes of management games; performance appraisal process; and problems with use of management games for appraisal. It is concluded that using management games in education is not compatible with using them for…

  12. Essays on Knowledge Management

    ERIC Educational Resources Information Center

    Xiao, Wenli

    2012-01-01

    For many firms, particularly those operating in high technology and competitive markets, knowledge is cited as the most important strategic asset to the firm, which significantly drives its survival and success (Grant 1996, Webber 1993). Knowledge management (KM) impacts the firm's ability to develop process features that reduce manufacturing…

  13. Managing 'tail liability'.

    PubMed

    Frese, Richard C; Weber, Ryan J

    2013-11-01

    To reduce and control their level of tail liability, hospitals should: Utilize a self-insurance vehicle; Consider combined limits between the hospital and physicians; Communicate any program changes to the actuary, underwriter, and auditor; Continue risk management and safety practices; Ensure credit is given to the organization's own medical malpractice program. PMID:24340649

  14. Automotive energy management system

    SciTech Connect

    Shiber, S.

    1980-09-23

    A hydromechanical/hydrostatic automotive energy management system is described that is comprised of two hydraulic units, the system adapted to provide: an efficient, continuously variable optimal transmission ratio, an intermittent optimal engine operation in city traffic and regenerative braking, thereby, the system is able to reduce a car's fuel consumption by as much as one half while improving drivability.

  15. Identifying and Managing Risk.

    ERIC Educational Resources Information Center

    Abraham, Janice M.

    1999-01-01

    The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

  16. Prospects for Middle Management

    ERIC Educational Resources Information Center

    Lombardi, John

    1972-01-01

    This article is concerned with the status of middle management in the community college. Aspects discussed include the dual role of the chairman and alternative models of departmental organization which attempt to reduce separatism within the college. Community Colleges is a monthly supplement to Change magazine. (RN)

  17. Reducing stillbirths in low-income countries.

    PubMed

    Goldenberg, Robert L; Saleem, Sarah; Pasha, Omrana; Harrison, Margo S; Mcclure, Elizabeth M

    2016-02-01

    Worldwide, 98% of stillbirths occur in low-income countries (LIC), where stillbirth rates are ten-fold higher than in high-income countries (HIC). Although most HIC stillbirths occur prenatally, in LIC most stillbirths occur at term and during labor/delivery. Conditions causing stillbirths include those of maternal origin (obstructed labor, trauma, antepartum hemorrhage, preeclampsia/eclampsia, infection, diabetes, other maternal diseases), and fetal origin (fetal growth restriction, fetal distress, cord prolapse, multiples, malpresentations, congenital anomalies). In LIC, aside from infectious origins, most stillbirths are caused by fetal asphyxia. Stillbirth prevention requires recognition of maternal conditions, and care in a facility where fetal monitoring and expeditious delivery are possible, usually by cesarean section (CS). Of major causes, only syphilis and malaria can be managed prenatally. Targeting single conditions or interventions is unlikely to substantially reduce stillbirth. To reduce stillbirth rates, LIC must implement effective modern antepartum and intrapartum care, including fetal monitoring and CS. PMID:26577070

  18. Reducing discontinuation in family planning programs.

    PubMed

    Roberts, D; Panitchpakdi, P; Loevinsohn, B

    1993-01-01

    Management strategies for reducing discontinuation in family planning programs are summarized; the strategies are practical and show how to analyze data for women who stop using contraception. Common factors that are associated with high levels of discontinuation are identified. Recommendations are made for how program managers can change service delivery in order to improve client continuation. Understanding the size and nature of discontinuation is an important precursor to a solution. Data collection on discontinuation could be combined with a system for tracking and follow-up of individual clients. The reasons that women stop using contraception are identified as those which clinics can or cannot control. A clinic discontinues is one who is a "no show" within a reasonable period of time. Decisions need to be made about the type of discontinues to be tracked, e.g. all new acceptors or pill users only. How to identify no shows, how to use the daily register tracking system, and how to calculate discontinuation rates are described. A special daily record tracking system can be used to track clients over years and does not replace the client medical and reproductive history record. The advantages are that client forms to not have to be redesigned and staff training is simple. The disadvantages apply to large clinics and the need for ample filing areas and proper management. An example is given of a working solution in Kenya for a community-based distribution program. Discontinuation rates may be calculated in various ways; a more exact measure tends to be the most useful. Recalculating discontinuation rates at regular intervals can provide an effective way to check standards of care. A tally sheet can be used to track characteristics of discontinues; a sample is given and analyzed to show interpretations which point the way to program changes. Comparisons may be made by age, method type, length of use. An example is given of the Rwanda service delivery system and

  19. Reservoir management cost-cutting

    SciTech Connect

    Gulati, M.S.

    1996-12-31

    This article by Mohinder S. Gulati, Chief Engineer, Unocal Geothermal Operations, discusses cost cutting in geothermal reservoir management. The reservoir engineer or geoscientist can make a big difference in the economical outcome of a project by improving well performance and thus making geothermal energy more competitive in the energy marketplace. Bringing plants online in less time and proving resources to reduce the cycle time are some of the ways to reduce reservoir management costs discussed in this article.

  20. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  1. Rationalizing Management Information System Costs.

    ERIC Educational Resources Information Center

    Parden, Robert J.

    This paper examines the proposition that management information systems (MIS) for colleges and universities are not achieving their original objectives of supporting better management decisions by providing more and better information in a more timely manner. As a consequence, the MIS activity should be reduced in scope, and standardized to…

  2. Managing a successful organizational change.

    PubMed

    Conner, D R; Newman, J A

    1988-06-01

    To survive in today's competitive environment, hospitals must prepare themselves to effectively manage organizational changes such as downsizing or mergers. By analyzing the change process and understanding key roles, managers will be likely to ensure a smooth and successful transition. And a smooth and well-managed change will produce positive results by reducing the amount of time needed for the change to take affect, minimizing or avoiding productivity declines, keeping morale high, and encouraging confidence in hospital leadership. PMID:10287602

  3. Reducing the complexity of software systems - A strategic software perspective

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda S.

    1992-01-01

    The results of a combined management and technical initiative aimed at reducing the size and complexity associated with developing operations planning, scheduling, and resource management software systems are presented. The initiative has produced operations concepts, functional requirements, system architectures, a comprehensive lexicon, and software tools to revolutionize the traditional software technology and development practices for planning, scheduling, and resource management systems used in space operations control centers. Examples of technology and practices to reduce complexity include a method for projecting design consequences from an operations concept, a universal architecture for heuristic algorithms, an object-oriented framework for describing large classes of problems that parametrically adapt to all domain peculiarities, the identification of general approaches which respond to changes with minimum impact on systems implementations, and a management structure for prototyping to minimize the risks of ill-conceived designs.

  4. Oxygen-reducing catalyst layer

    DOEpatents

    O'Brien, Dennis P.; Schmoeckel, Alison K.; Vernstrom, George D.; Atanasoski, Radoslav; Wood, Thomas E.; Yang, Ruizhi; Easton, E. Bradley; Dahn, Jeffrey R.; O'Neill, David G.

    2011-03-22

    An oxygen-reducing catalyst layer, and a method of making the oxygen-reducing catalyst layer, where the oxygen-reducing catalyst layer includes a catalytic material film disposed on a substrate with the use of physical vapor deposition and thermal treatment. The catalytic material film includes a transition metal that is substantially free of platinum. At least one of the physical vapor deposition and the thermal treatment is performed in a processing environment comprising a nitrogen-containing gas.

  5. Interpreting Financial Results. Financial Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    ERIC Educational Resources Information Center

    Adamson, Jan; And Others

    One of a series of three self-instructional units, these materials are aimed at helping British hotel and catering managers improve profits and/or reduce costs in their areas of responsibility. Following an introduction and a paragraph on how to use the unit, section 1 covers how to use management information. The section includes these trainee…

  6. Team Management: Quick Relief from the Minor Aches and Pains of School Business Management.

    ERIC Educational Resources Information Center

    Stevens, Kenneth R.; Pellicer, Leonard O.

    1984-01-01

    The use of the management team approach by school business officials will result in increased operational efficiency, greater accountability, better decisions, less crisis management, reduced stress, and increased job satisfaction. (MLF)

  7. Managed Care

    MedlinePlus

    Managed care plans are a type of health insurance. They have contracts with health care providers and medical ... probably cost more. There are three types of managed care plans: Health Maintenance Organizations (HMO) usually only pay ...

  8. Stress Management

    MedlinePlus

    ... Awards Healthy Workplace Food and Beverage Toolkit Stress Management Banner 1 - To Stress or Not to Stress - ... Decide But We Can Help What Is Stress Management? Banner 2 - Stress Continuum Graphic Banner Live life ...

  9. Manage Stress

    MedlinePlus

    ... Manage Stress Print This Topic En español Manage Stress Browse Sections The Basics Overview Signs and Health ... and Health Effects What are the signs of stress? When people are under stress, they may feel: ...

  10. In Brief: Reducing black carbon emissions could immediately reduce global temperature increases

    NASA Astrophysics Data System (ADS)

    Tretkoff, Ernie

    2011-03-01

    A new assessment by the United Nations Environment Programme (UNEP) shows that measures to reduce emissions of black carbon, or soot, which is produced through burning of wood and other biofuels as well as by some industrial processes, could improve public health and help to significantly reduce projected global temperature increases. The Integrated Assessment of Black Carbon and Tropospheric Ozone highlights how specific measures targeting black carbon and other emissions from fossil fuel extraction, residential wood-burning cooking, diesel vehicles, waste management, agriculture, and small industries could affect climate. Full implementation of a variety of measures to reduce black carbon and methane emissions could reduce future global warming by about 0.5°C, the assessment found. Reducing black carbon could have substantial benefits in the Arctic, the Himalayas, and other snow-covered regions because black carbon that settles on top of snow absorbs heat, speeding melting of snow and ice. Black carbon emission reductions would affect global temperatures more quickly than carbon dioxide emission reductions. Furthermore, reducing black carbon emissions would improve public health in the regions that emit large amounts of the harmful air pollutant.

  11. Reducing societal vulnerability to drought: A methodology

    SciTech Connect

    Wilhite, D.A.

    1995-12-31

    Given worldwide experience with drought during the past several decades and the magnitude of associated impacts, it is apparent that vulnerability to extended periods of water shortage is escalating. Developing a national or provincial drought policy and preparedness plan is a complicated but essential first step toward reducing societal vulnerability. Until recently, nations had devoted little effort to drought preparedness, preferring instead the reactive or crisis management approach. Presently, an increasing number of nations are pursuing a more proactive approach that emphasizes the principles of risk management and sustainable development. Because of the multitude of impacts associated with drought and the numerous governmental agencies that have responsibility for some aspect of monitoring, assessment, mitigation, and planning, developing a policy and plan must be an integrated process within and between levels of government. This paper outlines a generic process that can be adopted by governments that desire to develop a more comprehensive and long-term approach to drought management and planning. Countries and states or provincial authorities that have adopted this approach is presented as case studies. This process is timely, given the declaration of the 1990s as the International Decade for Natural Disaster Reduction and the recent International Convention to Combat Desertification and Drought (June, 1994), an offshoot of deliberations at the United Nations Conference on Environment and Development.

  12. Time Management

    ERIC Educational Resources Information Center

    Stoilov, Todor, Ed.

    2012-01-01

    The time management is worthy goal of many human activities. It concerns variety problems related to goals definition, assessment of available resources, control of management policies, scheduling of decisions. This book is an attempt to illustrate the decision making process in time management for different success stories, which can be used as…

  13. Managing Success.

    ERIC Educational Resources Information Center

    Gaydon, Tony

    2002-01-01

    Offers guidelines to ensure a smooth school construction project: (1) validate the program and budget; (2) create a management plan; (3) develop a reporting system; (4) qualify designers; (5) manage the design phase; (6) put the schedule in bidding documents; and (6) closely manage the construction phase. (EV)

  14. Cash Management.

    ERIC Educational Resources Information Center

    Fischer, Mary L.; Ostrom, John S.

    1982-01-01

    Elements of an effective management program for colleges and universities are examined. Five basic purposes of an effective program of cash management are identified: developing accurate cash projections, managing cash receipts, controlling cash disbursements, establishing sound banking relationships, and investing funds. It is suggested that all…

  15. Team Management.

    ERIC Educational Resources Information Center

    Lindelow, John

    Chapter 5 of a volume on school leadership, this chapter reviews the literature to define and explain management teams and to describe several successful management team arrangements. The author begins by noting that team management has recently enjoyed a resurgence as a response to collective negotiations, but beyond this function can have value…

  16. Adaptive Management for Urban Watersheds: The Slavic Village Pilot Project

    EPA Science Inventory

    Adaptive management is an environmental management strategy that uses an iterative process of decision-making to reduce the uncertainty in environmental management via system monitoring. A central tenet of adaptive management is that management involves a learning process that ca...

  17. Reducing polypharmacy in extended care.

    PubMed

    Hamdy, R C; Moore, S W; Whalen, K; Donnelly, J P; Compton, R; Testerman, F; Haulsee, P; Hughes, J

    1995-05-01

    In this 5-year prospective study, we determined the feasibility of reducing polypharmacy in a long-term care institution by a systematic review of the pharmacy records. At 6-month intervals, the computer printout of all medications prescribed to patients in a 550-bed institution was reviewed. After patients taking more than 10 different drugs were identified, their physician was notified and was asked to review their medications according to specific guidelines. The number of patients taking 10 or more medications was reduced from 67, when the program was started, to 9. The average number of medications per patient was reduced from 5.5 to 4.6. This program reduced the prevalence of polypharmacy and had long-lasting effects on the physicians' prescribing habits. We also believe it led to improved patient care by reducing the potential for drug interactions and to cost savings for the pharmacy. PMID:7732442

  18. Managing diversity.

    PubMed

    Epting, L A; Glover, S H; Boyd, S D

    1994-06-01

    The U.S. work force is becoming increasingly diverse as the 20th century approaches. Statistics prove that most organizations are experiencing gender, culture, and age diversity within their labor forces. All managers and leaders must accept this diversity and work to handle it effectively. This article examines the current literature concerning management of diversity and its implications for the health care profession. Gender, culture, and age diversity and the potential problems that may arise with each are also addressed. Reasons to manage diversity are offered, as well as methods of managing diversity for both the manager and the chief executive officer. PMID:10134144

  19. Reducing Risk for the Next Generation Nuclear Plant

    SciTech Connect

    John M. Beck II; Harold J. Heydt; Emmanuel O. Opare; Kyle B. Oswald

    2010-07-01

    The Next Generation Nuclear Plant (NGNP) Project, managed by the Idaho National Laboratory (INL), is directed by the Energy Policy Act of 2005, to research, develop, design, construct, and operate a prototype forth generation nuclear reactor to meet the needs of the 21st Century. As with all large projects developing and deploying new technologies, the NGNP has numerous risks that need to be identified, tracked, mitigated, and reduced in order for successful project completion. A Risk Management Plan (RMP) was created to outline the process the INL is using to manage the risks and reduction strategies for the NGNP Project. Integral to the RMP is the development and use of a Risk Management System (RMS). The RMS is a tool that supports management and monitoring of the project risks. The RMS does not only contain a risk register, but other functionality that allows decision makers, engineering staff, and technology researchers to review and monitor the risks as the project matures.

  20. [How to reduce unnecessary orders of laboratory tests].

    PubMed

    Shimbuno, Ayumi; Noharai, Masanobu; Enomoto, Makoto; Higa, Yukie; Araya, Kiyoshi; Ota, Toshiyuki

    2011-06-01

    The medical insurance system in Japan has been focusing on how to reduce the annual increases in medical expenses. In this context, the circumstances in the laboratory department in large hospitals have been growing more strict. Therefore, medical staff working in large hospitals need to know how to reduce the expenditure consumed in laboratory tests. In this paper we report economical loss resulted from physicians' excessive test-orders and suggest how to manage the problem. PMID:21702125

  1. Communicating Risk to Program Managers

    NASA Technical Reports Server (NTRS)

    Shivers, C. Herbert

    2005-01-01

    Program Managers (PM) can protect program resources and improve chances of success by anticipating, understanding and managing risks. Understanding the range of potential risks helps one to avoid or manage the risks. A PM must choose which risks to accept to reduce fire fighting, must meet the expectations of stakeholders consistently, and avoid falling into costly "black holes" that may open. A good risk management process provides the PM more confidence to seize opportunities save money, meet schedule, even improve relationships with people important to the program. Evidence of managing risk and sound internal controls can mean better support from superiors for the program by building a trust and reputation from being on top of issues. Risk managers have an obligation to provide the PM with the best information possible to allow the benefits to be realized (Small Business Consortium, 2004). The Institute for Chartered Accountants in England and Wales sees very important benefits for companies in providing better information about what they do to assess and manage key business risks. Such information will: a) provide practical forward-looking information; b) reduce the cost of capital; c) encourage better risk management; and d) improve accountability for stewardship, investor protection and the usefulness of financial reporting. We are particularly convinced that enhanced risk reporting will help listed companies obtain capital at the lowest possible cost (The Institute of Chartered Accountants in England &Wales, June 2002). Risk managers can take a significant role in quantifying the success of their department and communicating those figures to executive (program) management levels while pushing for a broader risk management role. Overall, risk managers must show that risk management work matters in the most crucial place-the bottom line- as they prove risk management can be a profit center (Sullivan, 2004).

  2. 41 CFR 109-43.307-4 - Conditional gifts to reduce the public debt.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... reduce the public debt. 109-43.307-4 Section 109-43.307-4 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.3-Utilization of Excess §...

  3. 41 CFR 109-43.307-4 - Conditional gifts to reduce the public debt.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... reduce the public debt. 109-43.307-4 Section 109-43.307-4 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.3-Utilization of Excess §...

  4. 41 CFR 109-43.307-4 - Conditional gifts to reduce the public debt.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... reduce the public debt. 109-43.307-4 Section 109-43.307-4 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.3-Utilization of Excess §...

  5. 41 CFR 109-43.307-4 - Conditional gifts to reduce the public debt.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... reduce the public debt. 109-43.307-4 Section 109-43.307-4 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.3-Utilization of Excess §...

  6. 76 FR 31886 - Reducing Regulatory Burden; Retrospective Review Under E.O. 13563

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... MANAGEMENT 5 CFR Chapters I and XXXV 45 CFR Chapter VIII 48 CFR Chapters 16, 17, and 21 Reducing Regulatory Burden; Retrospective Review Under E.O. 13563 AGENCY: Office of Personnel Management. ACTION: Request for information. SUMMARY: The Office of Personnel Management has posted on its public open government Web site...

  7. 41 CFR 109-43.307-4 - Conditional gifts to reduce the public debt.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... reduce the public debt. 109-43.307-4 Section 109-43.307-4 Public Contracts and Property Management Federal Property Management Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.3-Utilization of Excess §...

  8. Teaching Managers How to Manage

    SciTech Connect

    Hylko, J.M.

    2006-07-01

    Following graduation from a college or university with a technical degree, or through years of experience, an individual's training and career development activities typically focus on enhancing technical problem-solving skills. However, as these technical professionals, herein referred to as 'Techies', advance throughout their careers, they may be required to accept and adapt to the role of being a manager, and must undergo a transition to learn and rely on new problem-solving skills. However, unless a company has a specific manager-trainee class to address this subject and develop talent from within, an employee's management style is learned and developed 'on the job'. Both positive and negative styles are nurtured by those managers having similar qualities. Unfortunately, a negative style often contributes to the deterioration of employee morale and ultimate closing of a department or company. This paper provides the core elements of an effective management training program for 'Teaching Managers How to Manage' derived from the Department of Energy's Integrated Safety Management System and the Occupational Safety and Health Administration 's Voluntary Protection Program. Discussion topics and real-life examples concentrate on transitioning an employee from a 'Techie' to a manager; common characteristics of being a manager; the history and academic study of management; competition, change and the business of waste management; what to do after taking over a department by applying Hylko's Star of Success; command media; the formal and informal organizational charts; chain of command; hiring and developing high-degree, autonomous employees through effective communication and delegation; periodic status checks; and determining if the program is working successfully. These common characteristics of a strong management/leadership culture and practical career tips discussed herein provide a solid foundation for any company or department that is serious about developing

  9. Climate change and disaster management.

    PubMed

    O'Brien, Geoff; O'Keefe, Phil; Rose, Joanne; Wisner, Ben

    2006-03-01

    Climate change, although a natural phenomenon, is accelerated by human activities. Disaster policy response to climate change is dependent on a number of factors, such as readiness to accept the reality of climate change, institutions and capacity, as well as willingness to embed climate change risk assessment and management in development strategies. These conditions do not yet exist universally. A focus that neglects to enhance capacity-building and resilience as a prerequisite for managing climate change risks will, in all likelihood, do little to reduce vulnerability to those risks. Reducing vulnerability is a key aspect of reducing climate change risk. To do so requires a new approach to climate change risk and a change in institutional structures and relationships. A focus on development that neglects to enhance governance and resilience as a prerequisite for managing climate change risks will, in all likelihood, do little to reduce vulnerability to those risks. PMID:16512862

  10. [Clinical management. Clinical management units. Management agreements].

    PubMed

    Ortega Moreno, A

    2003-12-01

    Clinical management (CM) as a concept includes different innovating experiences in health care services management among developed countries, which were initiated during the late eighties and the first nineties. They were mostly due to the concern that political leaders had about their financial viability. CM, as far as it is understood in Spain, is an organizing model which considers the patient as the centre of the health system. It is guided towards disease, looking for continuous assistance and facilitates an autonomous management together with decentralization at the time of taking decisions. It involves professionals whose clinical practice, based on guides, medical records and care planning, incorporate the knowledge and methodology of "evidence based medicine". Clinical management units (CMU) are organizational types of CM, which implantation is spreading rapidly in the different national health care systems. They include a person who assumes responsibility for them, who act as the hospital directorship interlocutor and are autonomous at the time of managing the allocated resources related to their medical programmes and services. They have an information system adapted to their own needs and an outcome evaluation system which allows them "process" re-engineering. CMU's strengths and weaknesses are highly dependent on the professionals that integrate them. The CMU responsible carries out a management contract with the hospital directorship in which CMU competences, directorship's obligations, essential aspects to meet agreed goals, an outcome evaluation system and an incentives scheme are included. PMID:15206333

  11. Reducing Cancer Patients' Painful Treatment

    NASA Video Gallery

    A NASA light technology originally developed to aid plant growth experiments in space has proved to reduce the painful side effects resulting from chemotherapy and radiation treatment in bone marro...

  12. Reduced Gravity Education Flight Program

    NASA Video Gallery

    NASA'€™s Reduced Gravity Education Flight Program gives students and educators the opportunity to design, build and fly an experiment in microgravity and get a look at what it takes to be a NASA en...

  13. Reducing Childhood Obesity: We Can!

    MedlinePlus

    ... this page please turn Javascript on. Feature: Reducing Childhood Obesity We Can! Past Issues / Spring - Summer 2010 Table ... Promotes Healthier Children We Can! is a national childhood obesity prevention program sponsored by the National Heart, Lung, ...

  14. How to Reduce Solid Waste.

    ERIC Educational Resources Information Center

    Martins, George; Clapp, Leallyn B.

    1974-01-01

    Discusses the problem of solid waste disposal in the United States, suggests ways in which solid wastes might be reduced, and proposes a number of related topics for student debate in classes or in science clubs. (JR)

  15. Portfolio Management

    NASA Technical Reports Server (NTRS)

    Duncan, Sharon L.

    2011-01-01

    Enterprise Business Information Services Division (EBIS) supports the Laboratory and its functions through the implementation and support of business information systems on behalf of its business community. EBIS Five Strategic Focus Areas: (1) Improve project estimating, planning and delivery capability (2) Improve maintainability and sustainability of EBIS Application Portfolio (3) Leap forward in IT Leadership (4) Comprehensive Talent Management (5) Continuous IT Security Program. Portfolio Management is a strategy in which software applications are managed as assets

  16. Reduced Boil-Off System Sizing

    NASA Technical Reports Server (NTRS)

    Guzik, Monica C.; Plachta, David W.; Feller, Jeffrey R.

    2015-01-01

    NASA is currently developing cryogenic propellant storage and transfer systems for future space exploration and scientific discovery missions by addressing the need to raise the technology readiness level of cryogenic fluid management technologies. Cryogenic propellants are baselined in many propulsion systems due to their inherently high specific impulse; however, their low boiling points can cause substantial boil-off losses over time. Recent efforts such as the Reduced Boil-off Testing and the Active Thermal Control Scaling Study provide important information on the benefit of an active cooling system applied to LH2 propellant storage. Findings show that zero-boil off technologies can reduce overall mass in LH2 storage systems when low Earth orbit loiter periods extend beyond two months. A significant part of this mass reduction is realized by integrating two stages of cooling: a 20 K stage to intercept heat at the tank surface, and a 90 K stage to reduce the heat entering the less efficient 20 K stage. A missing element in previous studies, which is addressed in this paper, is the development of a direct method for sizing the 90 K cooling stage. Such a method requires calculation of the heat entering both the 90 K and 20 K stages as compared to the overall system masses, and is reliant upon the temperature distribution, performance, and unique design characteristics of the system in question. By utilizing the known conductance of a system without active thermal control, the heat being intercepted by a 90 K stage can be calculated to find the resultant lift and mass of each active thermal control stage. Integral to this is the thermal conductance of the cooling straps and the broad area cooling shield, key parts of the 90 K stage. Additionally, a trade study is performed to show the ability of the 90 K cooling stage to reduce the lift on the 20 K cryocooler stage, which is considerably less developed and efficient than 90 K cryocoolers.

  17. Integrated work management system.

    SciTech Connect

    Williams, Edward J., Jr.; Henry, Karen Lynne

    2010-06-01

    Sandia National Laboratories develops technologies to: (1) sustain, modernize, and protect our nuclear arsenal (2) Prevent the spread of weapons of mass destruction; (3) Provide new capabilities to our armed forces; (4) Protect our national infrastructure; (5) Ensure the stability of our nation's energy and water supplies; and (6) Defend our nation against terrorist threats. We identified the need for a single overarching Integrated Workplace Management System (IWMS) that would enable us to focus on customer missions and improve FMOC processes. Our team selected highly configurable commercial-off-the-shelf (COTS) software with out-of-the-box workflow processes that integrate strategic planning, project management, facility assessments, and space management, and can interface with existing systems, such as Oracle, PeopleSoft, Maximo, Bentley, and FileNet. We selected the Integrated Workplace Management System (IWMS) from Tririga, Inc. Facility Management System (FMS) Benefits are: (1) Create a single reliable source for facility data; (2) Improve transparency with oversight organizations; (3) Streamline FMOC business processes with a single, integrated facility-management tool; (4) Give customers simple tools and real-time information; (5) Reduce indirect costs; (6) Replace approximately 30 FMOC systems and 60 homegrown tools (such as Microsoft Access databases); and (7) Integrate with FIMS.

  18. Determining Reduced Order Models for Optimal Stochastic Reduced Order Models

    SciTech Connect

    Bonney, Matthew S.; Brake, Matthew R.W.

    2015-08-01

    The use of parameterized reduced order models(PROMs) within the stochastic reduced order model (SROM) framework is a logical progression for both methods. In this report, five different parameterized reduced order models are selected and critiqued against the other models along with truth model for the example of the Brake-Reuss beam. The models are: a Taylor series using finite difference, a proper orthogonal decomposition of the the output, a Craig-Bampton representation of the model, a method that uses Hyper-Dual numbers to determine the sensitivities, and a Meta-Model method that uses the Hyper-Dual results and constructs a polynomial curve to better represent the output data. The methods are compared against a parameter sweep and a distribution propagation where the first four statistical moments are used as a comparison. Each method produces very accurate results with the Craig-Bampton reduction having the least accurate results. The models are also compared based on time requirements for the evaluation of each model where the Meta- Model requires the least amount of time for computation by a significant amount. Each of the five models provided accurate results in a reasonable time frame. The determination of which model to use is dependent on the availability of the high-fidelity model and how many evaluations can be performed. Analysis of the output distribution is examined by using a large Monte-Carlo simulation along with a reduced simulation using Latin Hypercube and the stochastic reduced order model sampling technique. Both techniques produced accurate results. The stochastic reduced order modeling technique produced less error when compared to an exhaustive sampling for the majority of methods.

  19. Sprayer technology: reduce spray drift

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Enhancing environmental quality and sustaining the economic viability of food production are keys to sustainable agriculture. Modern vegetable production uses a variety of materials to manage pest problems. Selecting the proper spray nozzle for the application of liquid products is critical to red...

  20. Fungicides Can Reduce Pollination Potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Growers perform tasks to ensure a bountiful crop, including pest management which typically required the application of formulated herbicides, insecticides, and fungicides. Fungicides are frequently considered safe for use around bees, yet during the 2008 almond bloom, we noticed that bees stopped ...

  1. Scared or Prepared: Reducing Risks with School Security Assessments.

    ERIC Educational Resources Information Center

    Trump, Kenneth S.

    1999-01-01

    Prevention/intervention approaches such as violence-prevention curricula and conflict resolution are insufficient security measures. Three reasons for conducting school-security assessments are to prevent violence or prepare to manage it effectively, reduce risks and liability, and improve public relations by communicating commitment to school…

  2. Saccharomyces cerevisiae expressing bacteriophage endolysins reduce Lactobacillus contamination during fermentation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    One of the challenges facing the fuel ethanol industry is the management of bacterial contamination during fermentation. Lactobacillus species are the predominant contaminants that decrease the profitability of biofuel production by reducing ethanol yields and causing “stuck” fermentations, which i...

  3. Deficit irrigation of peach trees to reduce water consumption

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Lack of water is a major limiting factor for production tree fruits such as peaches in the San Joaquin Valley of California and many other arid- or semi-arid regions in the world. Deficit irrigation can be used in some cropping systems as a water resource management strategy to reduce non-productiv...

  4. Student Assistance Programs: New Approaches for Reducing Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Moore, David D.; Forster, Jerald R.

    1993-01-01

    Describes school-based Student Assistance Programs (SAPs), which are designed to reduce adolescents' substance abuse. Notes that SAPs, modeled after Employee Assistance Programs in workplace, are identifying, assessing, referring, and managing cases of substance-abusing students. Sees adoption of SAP model as accelerating in response to growing…

  5. STREAM RESTORATION STRATEGIES FOR REDUCING RIVER NITROGEN LOADS

    EPA Science Inventory

    Despite decades of work implementing agricultural and urban best management practices to reduce the movement of excess nitrogen (N) from the land to aquatic ecosystems, the amount of N moving down streams and rivers remains unacceptably high in many watersheds. During this same ...

  6. Behavioral intervention to reduce AIDS risk activities.

    PubMed

    Kelly, J A; St Lawrence, J S; Hood, H V; Brasfield, T L

    1989-02-01

    Behavior change can curtail the spread of acquired immune deficiency syndrome (AIDS). In this study, 104 gay men with a history of frequent AIDS high-risk behavior completed self-report, self-monitoring, and behavioral measures related to AIDS risk. The sample was randomly divided into experimental and waiting-list control groups. The experimental intervention provided AIDS risk education, cognitive-behavioral self-management training, sexual assertion training, and attention to the development of steady and self-affirming social supports. Experimental group participants greatly reduced their frequency of high-risk sexual practices and increased behavioral skills for refusing sexual coercions, AIDS risk knowledge, and adoption of "safer sex" practices. Change was maintained at the 8-month follow-up. PMID:2925974

  7. Interventions for reducing extinction risk in chytridiomycosis-threatened amphibians.

    PubMed

    Scheele, Ben C; Hunter, David A; Grogan, Laura F; Berger, Lee; Kolby, Jon E; McFadden, Michael S; Marantelli, Gerry; Skerratt, Lee F; Driscoll, Don A

    2014-10-01

    Wildlife diseases pose an increasing threat to biodiversity and are a major management challenge. A striking example of this threat is the emergence of chytridiomycosis. Despite diagnosis of chytridiomycosis as an important driver of global amphibian declines 15 years ago, researchers have yet to devise effective large-scale management responses other than biosecurity measures to mitigate disease spread and the establishment of disease-free captive assurance colonies prior to or during disease outbreaks. We examined the development of management actions that can be implemented after an epidemic in surviving populations. We developed a conceptual framework with clear interventions to guide experimental management and applied research so that further extinctions of amphibian species threatened by chytridiomycosis might be prevented. Within our framework, there are 2 management approaches: reducing Batrachochytrium dendrobatidis (the fungus that causes chytridiomycosis) in the environment or on amphibians and increasing the capacity of populations to persist despite increased mortality from disease. The latter approach emphasizes that mitigation does not necessarily need to focus on reducing disease-associated mortality. We propose promising management actions that can be implemented and tested based on current knowledge and that include habitat manipulation, antifungal treatments, animal translocation, bioaugmentation, head starting, and selection for resistance. Case studies where these strategies are being implemented will demonstrate their potential to save critically endangered species. PMID:24975971

  8. Strategies to Reduce Indoor Tanning

    PubMed Central

    Holman, Dawn M.; Fox, Kathleen A.; Glenn, Jeffrey D.; Guy, Gery P.; Watson, Meg; Baker, Katie; Cokkinides, Vilma; Gottlieb, Mark; Lazovich, DeAnn; Perna, Frank M.; Sampson, Blake P.; Seidenberg, Andrew B.; Sinclair, Craig; Geller, Alan C.

    2015-01-01

    Exposure to ultraviolet radiation from indoor tanning device use is associated with an increased risk of skin cancer, including risk of malignant melanoma, and is an urgent public health problem. By reducing indoor tanning, future cases of skin cancer could be prevented, along with the associated morbidity, mortality, and healthcare costs. On August 20, 2012, the CDC hosted a meeting to discuss the current body of evidence on strategies to reduce indoor tanning as well as research gaps. Using the Action Model to Achieve Healthy People 2020 Overarching Goals as a framework, the current paper provides highlights on the topics that were discussed, including (1) the state of the evidence on strategies to reduce indoor tanning; (2) the tools necessary to effectively assess, monitor, and evaluate the short- and long-term impact of interventions designed to reduce indoor tanning; and (3) strategies to align efforts at the national, state, and local levels through transdisciplinary collaboration and coordination across multiple sectors. Although many challenges and barriers exist, a coordinated, multilevel, transdisciplinary approach has the potential to reduce indoor tanning and prevent future cases of skin cancer. PMID:23683986

  9. Reduced waste generation, FY 1986

    SciTech Connect

    Not Available

    1986-02-01

    The United States Department of Energy is committed to the principles of minimizing the quantity and transuranic content of its transuranium (TRU) waste being generated at its nuclear facilities. The reasons are to reduce costs associated with waste handling and disposal, and also to reduce radiation exposure to workers and risk for radionuclide release to man and the environment. The purpose of this document is to provide the USDOE with a plan of research and development tasks for waste minimization, and is prepared so as to provide the maximum impact on volumes based on cost/benefit factors. The document is to be updated annually or as needed to reflect current and future tasks. The Reduced Waste Generation (RWG) tasks encompass a wide range of activities with the principal goals of (1) preventing the generation of waste and (2) converting TRU waste into low-level wastes (LLW) by sorting or decontamination. Concepts for reducing the volume such as in incineration and compaction are considered within the discipline of Reduced Waste Generation, but are considered as somewhat developed technology with only a need for implementation. 33 refs.

  10. Management of obesity.

    PubMed

    Bray, George A; Frühbeck, Gema; Ryan, Donna H; Wilding, John P H

    2016-05-01

    A modern approach to obesity acknowledges the multifactorial determinants of weight gain and the health benefits to be derived from weight loss. Foundational to any weight loss effort is lifestyle change, diet, and increased physical activity. The approach should be a high quality diet to which patients will adhere accompanied by an exercise prescription describing frequency, intensity, type, and time with a minimum of 150 min moderate weekly activity. For patients who struggle with weight loss and who would receive health benefit from weight loss, management of medications that are contributing to weight gain and use of approved medications for chronic weight management along with lifestyle changes are appropriate. Medications approved in the USA or European Union are orlistat, naltrexone/bupropion, and liraglutide; in the USA, lorcaserin and phentermine/topiramate are also available. Surgical management (gastric banding, sleeve gastrectomy, and Roux-en Y gastric bypass) can produce remarkable health improvement and reduce mortality for patients with severe obesity. PMID:26868660

  11. Managing change: an overview.

    PubMed

    Lorenzi, N M; Riley, R T

    2000-01-01

    As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics. PMID:10730594

  12. Electronic surgical record management.

    PubMed

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  13. ALS Project Management Manual

    SciTech Connect

    Krupnick, Jim; Harkins, Joe

    2000-05-01

    This manual has been prepared to help establish a consistent baseline of management practices across all ALS projects. It describes the initial process of planning a project, with a specific focus on the production of a formal project plan. We feel that the primary weakness in ALS project management efforts to date stems from a failure to appreciate the importance of ''up-front'' project planning. In this document, we present a guide (with examples) to preparing the documents necessary to properly plan, monitor, and control a project's activities. While following the manual will certainly not guarantee good project management, failure to address the issues we raise will dramatically reduce the chance of success. Here we define success as meeting the technical goals on schedule and within the prescribed budget.

  14. Pain management in newborns.

    PubMed

    Hall, Richard W; Anand, Kanwaljeet J S

    2014-12-01

    As a standard of care for preterm/term newborns effective pain management may improve their clinical and neurodevelopmental outcomes. Neonatal pain is assessed using context-specific, validated, and objective pain methods, despite the limitations of currently available tools. Therapeutic approaches reducing invasive procedures and using pharmacologic, behavioral, or environmental measures are used to manage neonatal pain. Nonpharmacologic approaches like kangaroo care, facilitated tucking, non-nutritive sucking, sucrose, and others can be used for procedural pain or adjunctive therapy. Local/topical anesthetics, opioids, NSAIDs/acetaminophen and other sedative/anesthetic agents can be incorporated into NICU protocols for managing moderate/severe pain or distress in all newborns. PMID:25459780

  15. Microbial methods of reducing technetium

    DOEpatents

    Wildung, Raymond E [Richland, WA; Garland, Thomas R [Greybull, WY; Gorby, Yuri A [Richland, WA; Hess, Nancy J [Benton City, WA; Li, Shu-Mei W [Richland, WA; Plymale, Andrew E [Richland, WA

    2001-01-01

    The present invention is directed toward a method for microbial reduction of a technetium compound to form other compounds of value in medical imaging. The technetium compound is combined in a mixture with non-growing microbial cells which contain a technetium-reducing enzyme system, a stabilizing agent and an electron donor in a saline solution under anaerobic conditions. The mixture is substantially free of an inorganic technetium reducing agent and its reduction products. The resulting product is Tc of lower oxidation states, the form of which can be partially controlled by the stabilizing agent. It has been discovered that the microorganisms Shewanella alga, strain Bry and Shewanelia putrifacians, strain CN-32 contain the necessary enzyme systems for technetium reduction and can form both mono nuclear and polynuclear reduced Tc species depending on the stabilizing agent.

  16. Reducing the Consequences of a Nuclear Detonation.

    SciTech Connect

    Buddemeier, B R

    2007-11-09

    The 2002 National Strategy to Combat Weapons of Mass Destruction states that 'the United States must be prepared to respond to the use of WMD against our citizens, our military forces, and those of friends and allies'. Scenario No.1 of the 15 Department of Homeland Security national planning scenarios is an improvised nuclear detonation in the national capitol region. An effective response involves managing large-scale incident response, mass casualty, mass evacuation, and mass decontamination issues. Preparedness planning activities based on this scenario provided difficult challenges in time critical decision making and managing a large number of casualties within the hazard area. Perhaps even more challenging is the need to coordinate a large scale response across multiple jurisdictions and effectively responding with limited infrastructure and resources. Federal response planning continues to make improvements in coordination and recommending protective actions, but much work remains. The most critical life-saving activity depends on actions taken in the first few minutes and hours of an event. The most effective way to reduce the enormous national and international social and economic disruptions from a domestic nuclear explosion is through planning and rapid action, from the individual to the federal response. Anticipating response resources for survivors based on predicted types and distributions of injuries needs to be addressed.

  17. After-school enrichment and the activity theory: How can a management service organization assist schools with reducing the achievement gap among minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours?

    NASA Astrophysics Data System (ADS)

    Flowers, Reagan D.

    The primary purpose of this study was to investigate how a management service organization can assist schools with reducing the achievement gap between minority and non-minority students in science, technology, engineering, and mathematics (STEM) during the after-school hours. Developing a strategic plan through creating a program that provides support services for the implementation of hands-on activities in STEM for children during the after-school hours was central to this purpose. This Project Demonstrating Excellence (PDE), a social action project, also presents historical and current after-school program developments in the nation. The study is quantitative and qualitative in nature. Surveys were utilized to quantitatively capture the opinions of participants in the social action project on three specific education related issues: (1) disparity in academic motivation of students to participate in after-school STEM enrichment programs; (2) whether teachers and school administrators saw a need for STEM after-school enrichment; and (3) developing STEM after-school programs that were centered on problem-solving and higher-order thinking skills to develop students' interest in STEM careers. The sample consisted of 50 participants comprised of students, teachers, and administrators. The focus groups and interviews provided the qualitative data for the study. The qualitative sample consisted of 14 participants comprised of students, parents and teachers, administrators, an education consultant, and a corporate sponsor. The empirical data obtained from the study survey, focus groups, and interviews provided a comprehensive profile on the current views and future expectations of STEM after-school enrichment, student and school needs, and community partnerships with STEM companies. Results of the study and review of the implementation of the social action project, C-STEM (communication, science, technology, engineering, and mathematics) Teacher and Student Support

  18. Watershed management

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Watershed management is aimed at land and water resources, and is applied to an area of land that drains to a defined location along a stream or river. Watershed management aims to care for natural resources in a way that supports human needs for water, food, fiber, energy, and habitation, while sup...

  19. Management Development.

    ERIC Educational Resources Information Center

    1997

    This document contains three papers from a symposium on management development. "LMX (Leader-Member Exchange) Theory, Personality Type, and Management Development" (Janet Z. Burns) reports the results of a study on the similarities and differences in personality type (as outlined in the theories of Carl Jung and Isabel Myers) and its relationship…

  20. Knowledge Management.

    ERIC Educational Resources Information Center

    1999

    The first of the four papers in this symposium, "Knowledge Management and Knowledge Dissemination" (Wim J. Nijhof), presents two case studies exploring the strategies companies use in sharing and disseminating knowledge and expertise among employees. "A Theory of Knowledge Management" (Richard J. Torraco), develops a conceptual framework for…

  1. Construction Management.

    ERIC Educational Resources Information Center

    Abbott, James F.

    This article provides a detailed discussion of a team approach to building that involves a construction manager, an architect, and a contractor. Bidding methods are outlined; the major components in construction management -- value engineering and fast track scheduling -- and the use of performance specifications are discussed. The construction…

  2. Inventory Management

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Known as MRO for Maintenance, Repair and Operating supplies, Tropicana Products, Inc.'s automated inventory management system is an adaptation of the Shuttle Inventory Management System (SIMS) developed by NASA to assure adequate supply of every item used in support of the Space Shuttle. The Tropicana version monitors inventory control, purchasing receiving and departmental costs for eight major areas of the company's operation.

  3. Conflict Management.

    ERIC Educational Resources Information Center

    Fisher, William; Koue, Glen

    1991-01-01

    Discusses general issues involved in conflict management and provides more specific examples of conflict management in libraries. Causes of conflict are considered, including organizational structure, departmentalization, performance appraisal, poor communication, and technological change; and methods of dealing with conflict are described,…

  4. Classroom Management.

    ERIC Educational Resources Information Center

    Dinsmore, Terri Sue

    This paper is a report of a middle-school teacher's study of classroom management. The teacher/researcher was interested in how some of the techniques in the Kovalik Integrated Thematic Instruction model of training would influence the teacher/researcher's classroom management; the effects of direct instruction within a community circle; the…

  5. Management Manual.

    ERIC Educational Resources Information Center

    San Joaquin Delta Community Coll. District, CA.

    This manual articulates the rights, responsibilities, entitlements, and conditions of employment of management personnel at San Joaquin Delta College (SJDC). The manual first presents SJDC's mission statement and then discusses the college's management goals and priorities. An examination of SJDC's administrative organization and a list of…

  6. Weight Management

    MedlinePlus

    ... Quit Smoking Benefits of Quitting Health Effects of Smoking Secondhand Smoke Withdrawal Ways to Quit QuitGuide Pregnancy & Motherhood Pregnancy & Motherhood Before Your Baby is Born From Birth to 2 Years Quitting for Two SmokefreeMom Healthy Kids Parenting & ... Weight Management Weight Management ...

  7. Environmental Management.

    ERIC Educational Resources Information Center

    Bandhu, Desh, Ed.

    The Indian Environmental Society, in association with the International Programme on Environmental Management Education, organized two seminars on World Environment Day and Environmental Impact Assessment during June 1980. A large number of papers on various aspects of environmental management were presented during the seminars. The papers…

  8. Clothing Management.

    ERIC Educational Resources Information Center

    Michigan State Univ., East Lansing. Coll. of Agriculture and Natural Resources Education Inst.

    This task-based curriculum guide for clothing management is intended to help the teacher develop a classroom management system where students learn by doing. Introductory materials include a Dictionary of Occupational Titles job code and title sheet, a career ladder, a matrix relating duty/task numbers to job titles, and a task list. Each task is…

  9. Supply Management.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    Developed as part of the Marine Corps Institute (MCI) correspondence training program, this course on supply management is designed to provide the supply chief with an understanding of the fundamental functions of supply management as it applies to a supply office. Introductory materials include specific information for MCI students, a course…

  10. Forest Management.

    ERIC Educational Resources Information Center

    Weicherding, Patrick J.; And Others

    This bulletin deals with forest management and provides an overview of forestry for the non-professional. The bulletin is divided into six sections: (1) What Is Forestry Management?; (2) How Is the Forest Measured?; (3) What Is Forest Protection?; (4) How Is the Forest Harvested?; (5) What Is Forest Regeneration?; and (6) What Is Forest…

  11. Reducing Design Cycle Time and Cost Through Process Resequencing

    NASA Technical Reports Server (NTRS)

    Rogers, James L.

    2004-01-01

    In today's competitive environment, companies are under enormous pressure to reduce the time and cost of their design cycle. One method for reducing both time and cost is to develop an understanding of the flow of the design processes and the effects of the iterative subcycles that are found in complex design projects. Once these aspects are understood, the design manager can make decisions that take advantage of decomposition, concurrent engineering, and parallel processing techniques to reduce the total time and the total cost of the design cycle. One software tool that can aid in this decision-making process is the Design Manager's Aid for Intelligent Decomposition (DeMAID). The DeMAID software minimizes the feedback couplings that create iterative subcycles, groups processes into iterative subcycles, and decomposes the subcycles into a hierarchical structure. The real benefits of producing the best design in the least time and at a minimum cost are obtained from sequencing the processes in the subcycles.

  12. Managing workers' compensation exposures in healthcare.

    PubMed

    McDonald, L

    1998-01-01

    Employees in healthcare are exposed to numerous and varied risks that pose the threat of injury. Management of those exposures by the organization will ultimately help create a safe environment for staff, patients and the public. Incorporating workers' compensation into the risk management program is the first step toward managing and reducing these exposures. This article presents a suggested outline for a written risk management plan for workers' compensation exposures. PMID:10182134

  13. A Privacy Manager for Cloud Computing

    NASA Astrophysics Data System (ADS)

    Pearson, Siani; Shen, Yun; Mowbray, Miranda

    We describe a privacy manager for cloud computing, which reduces the risk to the cloud computing user of their private data being stolen or misused, and also assists the cloud computing provider to conform to privacy law. We describe different possible architectures for privacy management in cloud computing; give an algebraic description of obfuscation, one of the features of the privacy manager; and describe how the privacy manager might be used to protect private metadata of online photos.

  14. Flexure Bearing Reduces Startup Friction

    NASA Technical Reports Server (NTRS)

    Clingman, W. Dean

    1991-01-01

    Design concept for ball bearing incorporates small pieces of shim stock, wire spokes like those in bicycle wheels, or other flexing elements to reduce both stiction and friction slope. In flexure bearing, flexing elements placed between outer race of ball bearing and outer ring. Elements flex when ball bearings encounter small frictional-torque "bumps" or even larger ones when bearing balls encounter buildups of grease on inner or outer race. Flexure of elements reduce high friction slopes of "bumps", helping to keep torque between outer ring and inner race low and more nearly constant. Concept intended for bearings in gimbals on laser and/or antenna mirrors.

  15. Pavement management

    SciTech Connect

    Ross, F.R.; Connor, B.; Lytton, R.L.; Darter, M.I.; Shahin, M.Y.

    1982-01-01

    The 11 papers in this report deal with the following areas: effect of pavement roughness on vehicle fuel consumption; rational seasonal load restrictions and overload permits; state-level pavement monitoring program; data requirements for long-term monitoring of pavements as a basis for development of multiple regression relations; simplified pavement management at the network level; combined priority programming of maintenance and rehabilitation for pavement networks; Arizona pavement management system: Phase 2-verification of performance prediction models and development of data base; overview of paver pavement management system; economic analysis of field implementation of paver pavement management system; development of a statewide pavement maintenance management system; and, prediction of pavement maintenance expenditure by using a statistical cost function.

  16. Risk management and EMS: what managers need to know.

    PubMed

    Patrick, Richard W

    2002-09-01

    Today's emergency service leader is faced with many administrative responsibilities. Much of this work involves protecting personnel against injury. It also involves reducing the effects of losses. To help reduce such problems, the umbrella of risk management and application of the principles of loss control should be used. A loss control program can identify existing or potential problems and provide the means to reduce or eliminate them. A comprehensive risk management program is a systematic method that helps you investigate and identify your problem areas and strategize methods to eliminate, prevent or safeguard against potential risk. It's an easy, straightforward approach that can provide positive results. As an emergency service manager, that's what you want--positive results! PMID:12239796

  17. Reducing violent injuries: priorities for pediatrician advocacy.

    PubMed

    Dolins, J C; Christoffel, K K

    1994-10-01

    A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries. PMID:7936890

  18. Reducing human nitrogen use for food production.

    PubMed

    Liu, Junguo; Ma, Kun; Ciais, Philippe; Polasky, Stephen

    2016-01-01

    Reactive nitrogen (N) is created in order to sustain food production, but only a small fraction of this N ends up being consumed as food, the rest being lost to the environment. We calculated that the total N input (TN) of global food production was 171 Tg N yr(-1) in 2000. The production of animal products accounted for over 50% of the TN, against 17% for global calories production. Under current TN per unit of food production and assuming no change in agricultural practices and waste-to-food ratios, we estimate that an additional TN of 100 Tg N yr(-1) will be needed by 2030 for a baseline scenario that would meet hunger alleviation targets for over 9 billion people. Increased animal production will have the largest impact on increasing TN, which calls for new food production systems with better N-recycling, such as cooperation between crop and livestock producing farms. Increased N-use efficiency, healthier diet and decreased food waste could mitigate this increase and even reduce TN in 2030 by 8% relative to the 2000 level. Achieving a worldwide reduction of TN is a major challenge that requires sustained actions to improve nitrogen management practices and reduce nitrogen losses into the environment. PMID:27445108

  19. Flirtation reduces males' fecundity but not longevity.

    PubMed

    Esfandi, Kambiz; He, Xiong Zhao; Wang, Qiao

    2015-08-01

    Theory predicts that due to limited resources males should strategically adjust their investment in reproduction and survival. Based on different conceptual framework, experimental designs, and study species, many studies support while others contradict this general prediction. Using a moth Ephestia kuehniella whose adults do not feed and thus have fixed resources for their lifetime fitness, we investigated whether males adjusted their investment in various life activities under dynamic socio-sexual environment. We allowed focal males to perceive rivals or additional females without physical contact. We show that males do not adjust the number of sperm they transfer to mates in a given copulation at different immediate or both immediate and mean sperm competition levels. Contradictory to general predictions, our results demonstrate that cues from additional females increase males' investment in courtship and reduce their lifetime number of copulations and sperm ejaculated, whereas cues from rivals have no effect on these parameters. Males have similar longevity in all treatments. We suggest that the sex pheromone produced by multiple females overstimulate males, increasing males' costly flirtations, and reducing their lifetime copulation frequency and fecundity. This finding offers a novel explanation for the success of mating disruption strategy using sex pheromones in pest management. PMID:26133013

  20. Reducing human nitrogen use for food production

    PubMed Central

    Liu, Junguo; Ma, Kun; Ciais, Philippe; Polasky, Stephen

    2016-01-01

    Reactive nitrogen (N) is created in order to sustain food production, but only a small fraction of this N ends up being consumed as food, the rest being lost to the environment. We calculated that the total N input (TN) of global food production was 171 Tg N yr−1 in 2000. The production of animal products accounted for over 50% of the TN, against 17% for global calories production. Under current TN per unit of food production and assuming no change in agricultural practices and waste-to-food ratios, we estimate that an additional TN of 100 Tg N yr−1 will be needed by 2030 for a baseline scenario that would meet hunger alleviation targets for over 9 billion people. Increased animal production will have the largest impact on increasing TN, which calls for new food production systems with better N-recycling, such as cooperation between crop and livestock producing farms. Increased N-use efficiency, healthier diet and decreased food waste could mitigate this increase and even reduce TN in 2030 by 8% relative to the 2000 level. Achieving a worldwide reduction of TN is a major challenge that requires sustained actions to improve nitrogen management practices and reduce nitrogen losses into the environment. PMID:27445108